CAJ | 학술논문

目的探讨层间积液综合征(IFS)的发病原因、临床表现、激光扫描共焦显微镜检查特点以及治疗中存在问题.方法回顾性系列病例研究.对河南省眼科研究所2007年1月至2011年10月诊治的8例IFS患者的临床资料包括性别、年龄、病史等详细询问并行裂隙灯显微镜、眼前节相干光断层成像术(OCT)、激光扫描共焦显微镜以及眼底、视野等检查.结果 8例患者中双眼4例、单眼4例,共12只眼.男性6例,女性2例,年龄19 ～ 35岁.发病原因分别为准分子激光原位角膜磨镶术(LASIK)后糖皮质激素性高眼压2例(4只眼),原发性开角型青光眼2例(4只眼),青光眼-睫状体炎综合征1例(1只眼),色素性青光眼1例(1只眼),外伤性葡萄膜炎1例(1只眼),LASIK术后上皮植入反复冲洗内皮损伤1例(1只眼).裂隙灯显微镜检查可见角膜水肿、角膜层间混浊、层间积液；眼前节OCT检查可见角膜层间积液或混浊；激光扫描共焦显微镜检查可见角膜水肿,角膜瓣增厚,基质细胞减少,角膜皱褶.结论 IFS为LASIK术后严重威胁视力的并发症,发病原因主要为高眼压和角膜内皮损伤,详细的裂隙灯显微镜检查辅以眼前节OCT检查可明确诊断,针对不同原因早期合理治疗才能最大限度挽救患者视力.
목적 탐토층간적액종합정(IFS)적발병원인、림상표현、격광소묘공초현미경검사특점이급치료중존재문제.방법 회고성계렬병례연구.대하남성안과연구소2007년1월지2011년10월진치적8례IFS환자적림상자료포괄성별、년령、병사등상세순문병행렬극등현미경、안전절상간광단층성상술(OCT)、격광소묘공초현미경이급안저、시야등검사.결과 8례환자중쌍안4례、단안4례,공12지안.남성6례,녀성2례,년령19 ～ 35세.발병원인분별위준분자격광원위각막마양술(LASIK)후당피질격소성고안압2례(4지안),원발성개각형청광안2례(4지안),청광안-첩상체염종합정1례(1지안),색소성청광안1례(1지안),외상성포도막염1례(1지안),LASIK술후상피식입반복충세내피손상1례(1지안).렬극등현미경검사가견각막수종、각막층간혼탁、층간적액；안전절OCT검사가견각막층간적액혹혼탁；격광소묘공초현미경검사가견각막수종,각막판증후,기질세포감소,각막추습.결론 IFS위LASIK술후엄중위협시력적병발증,발병원인주요위고안압화각막내피손상,상세적렬극등현미경검사보이안전절OCT검사가명학진단,침대불동원인조기합리치료재능최대한도만구환자시력.
Objective To analysis the clinical characteristics of corneal interface fluid syndrome (IFS).Methods This is a retrospective study.During Jun.2007 to Oct.2011.Eight cases (12 eyes) of IFS were diagnosed at Henan Eye Institute.The history and complete ophthalmic examination that include Slit-lamp examination,Slit-lamp photography,IOP,anterior segment OCT (AS-OCT),confocal microscopic exams were recorded.Results In total 8 cases (12 eyes),4 cases were bilateral,4 cases were unilateral.Six patients were male and 2 were female.The age of the patients ranged from 19 to 35 years.Post-lasik steroid-induced elevated IOP was 4 eyes in 2 patients.Primary open angle glaucoma was 4 eyes in 2 patients.1 patient (1 eye) was Posner-Shlossman syndrome,1 patient (1 eye) was pigmented glaucoma,1 patient (1 eye) was post-lasik traumatic iritis.1 patient (1 eye) got IFS after repeated flap reposition because of epithelium ingrowth.Slit-lamp exam indicated edematous corneal,lamellar haze,interface fluids accumulation.AS-OCT showed obvious interface dark area.Confocal microscopy exam showed edematous corneal flap,more oval and large keratocytes' nuclei but no inflammatory cells.Conclusions IFS is a rare but serious complication after LASIK.The main causes are high intraocular pressure and/or dysfunction of corneal endothelium.Careful exam by slit-lamp may help diagnosis,and further AS-OCT and/or in vivo confocal microscopy exam will confirm it.