Abstract: The purpose of excimer laser in situ keratomileusis after a filamentous corneal diseases cause. Methods 439 cases of 869 patients with myopia of LASIK surgery before the tear film of the rupture time divided into two groups, A group BUT 5 ~ 10 s for a total of 187 cases 370, B Group BUT ≥ 10 s total of 252 cases 499. Results The two groups are the occurrence of filamentous keratopathy, A group of 14 are 10 cases, four cases of eye disease, accounting for 3.7 percent. BUT ≥ 10 s group in the two cases, no eye disease, accounting for 0.4 percent. Conclusion A group incidence rate was significantly higher than that in group B, that the tear film and the occurrence of filamentous corneal diseases are closely linked. Filamentous keratopathy is part of the corneal epithelial exfoliation, a filamentous volumes, one end attached to the corneal surface, the other end of the disease in free. Since 1990 Pallikaris reported use of laser in situ keratomileusis LASIK) for refractive errors, both at home and abroad on a number of related expositions, said a satisfactory effect. But after filamentous corneal disease prevention and treatment not yet reported. Although filamentous keratopathy had no effect on visual acuity, but symptoms can be caused by increasing the psychological burden of patients, the author will be in our hospital since August 2004 to February 2005 after LASIK among the 12 cases of corneal diseases cause of filamentous As follows.
1 clinical data
1.1 general from August 2004 to February 2005 to inter-hospital treatment centre parallel LASIK eye surgery ametropia a total of 439 cases with 869, aged 20 to 42 years old, for the refraction -1.50 ~ -16.00 D. All patients received on the preoperative examination, including the rupture time of tear film determination. According to BUT patients will be divided into two groups: A group BUT for 5 ~ 10 s are 187 cases of 370, B group BUT ≥ 10 s are 252 cases of 499. France heads are used Delia's Moria-Ⅱ production corneal flap, the United States Granville, as the company VISX-4 laser treatment. Before the letter to the benefit of proper eye drops anti-infection treatment, the Code will be after the Fourth Di Yan Shu eye drops on the 1st, continuing a week, a week after the switch to F on the 1st US-pupil eye drops four times, three weeks after the withdrawal. A total of 12 cases found after a 16 filamentous corneal diseases. A group of them in 10 cases, four cases of eye disease, accounting for 3.7 percent. Group B in the two cases, no eye disease, accounting for 0.4 percent.
1.2 clinical disease after more than occurred in two to eight weeks. Disease, the patient photophobia, tears, a foreign body sensation, two cases of obvious pain. Eye examination revealed a lesion on the cornea 1 to 5 of filamentous, fluorescence staining positive, multi-location at the bottom near the healing corneal flap.
Treatment and prognosis of 1.3 Cotton with saline injection needles and removal of filamentous, partial to Pui-Shu eye drops and antibiotic eye drops treatment. 10 patients were treated and 2 ~ 3 d recovery, cornea of filamentous disappeared, had no effect on visual acuity. Two patients repeatedly relapse after treatment with repeatedly recovered, the course for two months.
2 discussion
At present the cause of filamentous keratopathy is not very clear, and may be related to the following factors: ① epithelial cell proliferation or degeneration. ② basement membrane with a combination of abnormal elastic membrane. ③ abnormal tear film, like excessive mucus formation of the wire. More common in: dry eye, drug toxicity keratitis, and neurotrophic keratitis infection, and so on. In addition, the study found that in recent years, some eye surgeries can affect the membrane tears of normal physiological function, and the tear film dysfunction is the result of dry eye, the cornea of the eye disease complications such as major reasons. In this study, filamentous after LASIK corneal disease rate was 1.3 percent, in group A for 2.7%, B group was 0.4 percent. A group rate was significantly higher than that in group B, that the tear film and filamentous closely related to the occurrence of corneal diseases, the preoperative and postoperative dry eye after LASIK could become a filamentous keratopathy one of the incentives. At the same time, Zaidman, etc. [5] that the formation of filamentous corneal disease mechanisms: the end of Piji, basement membrane or elastic membrane before the injury resulted from the focal epithelial basement membrane, accompanied by blink cut eyelid movement of the impact from the site Since the corneal surface epithelial lifted, from the corneal surface disorders, leading to a large number of mucus and debris. From the epithelial mucus and debris as the receptor formation of filamentous cornea. LASIK surgery, while retaining the last stretch of the cortex and the former, but the margin inevitably led to the cortex and the former stretch of the injury and the epithelial cells of the focal detachment, thereby contributing to the occurrence of filamentous corneal diseases. This writer observed by the corneal diseases also filamentous margin, mostly in the vicinity. The group, filamentous higher proportion of corneal diseases, there may be two reasons: ① initial surgery in space for less reasonable, the operating room air-conditioning is on the patients. Corneal flap in the production process easy to dehydration, drying, its impact on a. ② early hormones after the large-scale use of eye drops, on the one hand affect the formation of the tear film, on the other hand also interfere with wound repair. To address the above reasons, I homes were adjusted accordingly, if I change the location of air-conditioning ventilation, exhaust straight to avoid patients with normal use of hormones in the category at the same time the use of moisturizing eye drops . Therefore, I believe that before and after effective treatment of dry eye, pay attention to the environment of temperature and humidity, and do a good corneal flap on the place after LASIK beneficial to reduce the occurrence of filamentous corneal diseases.
