临床医学毕业论文准分子激光角膜屈光术后皮质类固醇性高眼压的临床分析

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1、XX大学毕业论文准分子激光角膜屈光术后皮质类固醇性高眼压的临床分析姓名：2014年6月25日【摘要】目的：探讨准分子激光角膜屈光术后皮质类固醇性高眼压的发生率、临床特点及临床相关因素分析，为临床诊疗提供帮助。方法：对2005/2009年间我院行准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)或准分子激光上皮瓣下角膜磨镶术(lasersubepithelialkeratomileusis,LASER)的1580例3160眼术后皮质类固醇性高眼压患者的病历进行冋顾性分析总结。结果:冇38例68眼发生了高眼压

2、，其中男20例，女18例，年龄18〜33岁，术前屈光度为4.00〜12.00D,发病时间为手术后14〜30d,发生率为2.2%。其中LASIK术后继发皮质类固醇性高眼压的患者16例30眼，LASEK术后继发皮质类固醇性高眼压的患者22例38眼，38例68眼屮均为局部使用氟米龙或百力特滴眼液，用药时间20〜90d,视力不同程度下降及眼压升高，个别患者伴有角膜上皮水肿。停用糖皮质激素后根据眼压情况采用局部或全身降眼压药物治疗，所有患者视力恢复止常，症状消失，待眼压下降后将皮质类固醇滴眼液逐渐减量和停药。结论：准分子激光角膜屈光术后应用糖皮质激索滴眼

3、液可引起部分患者发生皮质类固醇性高眼压，应根据不同的临床特点给予充分的警惕，以免误诊漏诊。【关键词】皮质类固醇；高眼压；准分子激光角膜屈光手术AbstractAIM:Toanalyseandexploretheincidence,clinicalcharacteristicsandcorrelatedfactorsofsteroidsinducedhighintraocularpressure(IOP)aftercxcimcrlasercornearefractivesurgery,thenmakeahelptorclinic.METHODS:

4、RetrospectivestudyofhighIOPof1580patients(3160eyes)afterlaserinsitukeratomileusis(LASIK)orlasersubepithelialkeratomileusis(LASEK)from2005to2009wasperformedinourhospital.RESULTS:Sixtyeighteyesin38casesofsteroidsinducedhighIOPwererecognized.Theincidenceratewas2.2%.Therewere20m

5、alecasesand18femalecases.Theageofthepatientsrangedfrom1833yearsold.Thesphericalequivalentrefractionwere4.0012.00D.Itoccurredfrom1430daysafterexcimerlasercornearefractivesurgery.Therewere16cases(30eyes）and22cases38eyesoccurredsteroidsinducedhighIOPafterLASIKandLASEK,respectiv

6、ely.FluoromethoIoneorprednisoloneacetateeyedropsweretopicallyusedon68eyes.Thetimewitheyedropswasfrom20daysto90days.Theeyesightof38patients68eyesdecreasedwithdifferentdegreeandintraocularpressureincreased,andsomepatientshadcornealepitheliumedema・Theeyesightofallpatientsrecove

7、redtonormalandthesymptomsofthemdisappearedafterstopingthesteroids,andgivingtopicalorsystemicantiglaucomaagentsaccordingtopatients'intraocularpressure.CONCLUSION:TherewerespecialfeaturesinsteroidsinducedhighIOPaftercxcimcrlasercornearefractivesurgery.Theclinicianshouldpaymore

8、attentiontothesecasestoavoidmisdiagnosis.KEYWORDS:steroids;highintraocularp