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LASIK术后角膜层间积液综合征临床特点的系统评价
何晴
王秀
谷天瀑
解偲媛
魏瑞华
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20210310-00156
Clinical characteristics of interface fluid syndrome after LASIK: a systematic review
He Qing
Wang Xiu
Gu Tianpu
Xie Caiyuan
Wei Ruihua
Authors Info & Affiliations
He Qing
Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
Wang Xiu
Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
Gu Tianpu
Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
Xie Caiyuan
Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
Wei Ruihua
Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China
·
DOI： 10.3760/cma.j.cn115989-20210310-00156
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摘要

目的对准分子激光角膜原位磨镶术(LASIK)术后角膜层间积液综合征(IFS)的临床特点进行系统评价。

方法采用电子文献数据库，检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据库、中国科技期刊数据库关于角膜IFS文献报道，检索年限为1999—2021年。文章筛选、数据提取、质量评级及数据分析参照系统综述和Meta分析优先报告条目的PRISMA声明进行。

结果共纳入30篇文献，包括46例62眼病例，其中男34例47眼，女12例15眼；年龄19～69岁，平均(36.57±13.40)岁；双眼16例，单眼30例。85.48%(53/62)的IFS是由于LASIK术后眼压升高引起。纳入的46例62眼均有视力下降。其中24.19%(15/62)患眼出现眼痛、眼红、畏光。46例患者裂隙灯显微镜下均可见不同程度的角膜水肿、角膜层间积液，9.68%(6/62)患眼可见角膜后沉着物、前房细胞，16.13%(10/62)患眼出现视野损伤。治疗上77.42%(48/62)行降眼压药物治疗。有预后描述的31例40眼患者中，75.00%(30/40)患眼经治疗视力恢复，25.00%(10/40)视力无法恢复。

结论角膜IFS作为LASIK术后少见的并发症，在LASIK术后角膜水肿患者的诊断中应考虑此病，正确测量眼压，合理应用糖皮质激素及降眼压药物，避免不可恢复的视力下降。

准分子激光原位角膜磨镶术;角膜层间积液综合征;高眼压;系统评价
ABSTRACT

ObjectiveTo evaluate the clinical features of interface fluid syndrome (IFS) after laser in situ keratomileusis (LASIK).

MethodsWe searched PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, and Chinese Science and Technology Periodical Database for literature reports on IFS published from 1999 to 2021.Article selection, data extraction, quality rating, and data analysis were performed with reference to the PRISMA statement for priority reporting entities of systematic reviews and Meta-analysis.

ResultsA total of 30 publications were included, including 46 cases (62 eyes). Among them, 34 cases (47 eyes) were male and 12 cases (15 eyes) were female.Age ranged from 19 to 69 years with a mean of (36.57±13.40) years.There were 16 cases of bilateral eyes and 30 cases of monocular eyes.The 85.48% (53/62) of IFS was due to increased intraocular pressure (IOP) after LASIK.All 62 eyes included had decreased visual acuity.The 24.19% (15/62) of the affected eyes had ocular pain, redness, and photophobia.All 46 patients showed different degrees of corneal edema and interface fluid.Keratic precipitates and anterior chamber cells were visible in 9.68% (6/62) of the affected eyes, and 16.13% (10/62) showed visual field damage.IOP-lowering eye drops were given to 77.42% (48/62) of eyes.Of the 31 patients (40 eyes) with prognostic descriptions, and 75.00% (30/40) recovered their vision with treatment and 25.00% (10/40) did not.

ConclusionsIFS is a rare complication after LASIK.It should be considered in patients with corneal edema after LASIK.Proper measurement of IOP and reasonable application of glucocorticoids and IOP-lowering drops can prevent irreversible vision loss.

Laser in situ keratomileusis;Interface fluid syndrome;High intraocular pressure;Systematic review
Wei Ruihua, Email: nc.defudabe.umtiewr
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引用本文

何晴,王秀,谷天瀑,等. LASIK术后角膜层间积液综合征临床特点的系统评价[J]. 中华实验眼科杂志,2021,39(06)：557-562.

DOI:10.3760/cma.j.cn115989-20210310-00156

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角膜层间积液综合征(interface fluid syndrome，IFS)的报道主要见于准分子激光角膜原位磨镶术(laser in situ keratomileusis，LASIK)术后，是指在眼压升高和/或角膜内皮细胞损伤后，房水渗入角膜瓣与基质床间形成水样间隙，导致视力严重下降的一种角膜瓣相关的罕见术后并发症 [ 1 ]。由于疾病发病率低，临床表现较隐匿，易被临床医生忽视或误诊，出现不可逆的视力损伤。目前，国内外对IFS的报道较少，本研究拟通过系统评价的方法对现有证据进行总结，旨在深入探讨总结分析IFS的临床特点，为临床工作者提供有力的循证医学证据。
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魏瑞华，Email： nc.defudabe.umtiewr
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所有作者均声明不存在任何利益冲突
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国家自然科学基金项目 (81770901)
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