【摘要】 目的：分析眼球穿通伤的常见病因，确定这些病例的最终视力。方法：总共124例（124眼）年龄为6～60岁的眼球穿通伤患者就诊于Liaquat 大学眼科，分析眼球穿通伤的常见病因及最终视力。结果:本研究包括124例眼球穿通伤患者，平均年龄35（6～60）岁，男性为主，占86.3%，大多数患者小于20岁(71%)。眼球穿通伤最常见于职工，占76%。51%的患者最佳矫正视力位于光感至0.1之间。我们可靠记录了124例患者的最初视力和最终视力，结果发现不良的最终视力和差的最初视力之间关系密切。结论：眼球穿通伤是一种常见事故，尤其发生在青年男性中，常导致患者眼视力下降。缺乏保护措施的工作环境和儿童玩耍危险物品是常致严重的眼外伤的原因。
【关键词】 穿通性；眼外伤；视力结果·Original article·
Contact lens management of late onset bilateral keratectasia after laser in situ keratomileusis for myopia: a case report with review of literature
HongJun Du, Yuan Xu, Dan Hu, ZeHong Dong, HaiYan Wang, YuSheng Wang
Foundation item: National Science and Technology Projects Foundation of China(No.2004BA720A16)
Department of Ophthalmology, Xijing Hospital, the Fourth Military Medical University, Xian 710032, Shaanxi Province, China
AbstractAIM: To present a case of late onset bilateral keratectasis after laser in situ keratomileusis (LASIK) for myopia with rigid gaspermeable contact lenses with a brief review of literature on this subject.
METHODS: A 27yearold woman underwent bilateral uneventful LASIK for moderate myopia. Preoperative cycloplegic refractions were 5.50/0.50×50° right eye (OD) and 4.50/1.00×15° left eye (OS). Corneal pachymetry was 526μm OD and 541μm OS. Preoperative corneal topography was normal and did not reveal any keratoconus or forme fruste keratoconus. Following the creation of flaps with 160μm plates, ablations of 102μm OD and 86μm OS were performed, estimated to leave residual stromal beds of 264μm OD and 295μm OS.
RESULTS: Twentynine months postoperatively, the patient developed bilateral inferior keratectasia of 12.50/4.00×160° OD and 6.00/ 4.25×125° OS. Visual acuity was reduced in both eyes; the central cornea had steepened; and pachymetry showed central corneal thinning. Keratectasia was diagnosed, and rigid contact lenses were fitted. Three years later, the patient achieved satisfactory visual acuity and allday lens wear with minimal complications.
CONCLUSION: Late keratectasia may follow LASIK for low to moderate myopia despite a thorough preoperative workup. Rigid contact lenses can offer a safe, reversible option for improving visual acuity in such patients by delaying or avoiding the need for intracorneal ring segments implanting or penetrating keratoplasty.
KEYWORDS: keratoconus; myopia; Laser in situ keratomi leusis (LASIK); contact lens
Du HJ, Xu Y, Hu D, Dong ZH, Wang HY, Wang YS. Contact lens management of late onset bilateral keratectasia after laser in situ
keratomileusis for myopia: a case report with review of literature.
Int J Ophthalmol(Guoji Yanke Zazhi)2008;8(11):21672172
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