《眼科学》角膜病.ppt

角膜皮样瘤 角膜内上皮癌 角结膜鳞癌 角膜接触镜所致的并发症 1．角膜上皮水肿。 2．角膜新生血管上皮下的新生血管。 3．角膜上皮剥脱。 4．角膜溃疡。 5 ．睑结膜可出现巨乳头结膜炎。 ＊无论何种接触镜均不要戴镜过夜。 结膜乳头 屈光性角膜手术并发症 ①放射状角膜切开术 ②角膜松解切开和角膜楔形切除术 ③表面角膜镜片术 ④准分子激光屈光性角膜切削术 ⑤自动板层角膜成形术 LASIK术后感染性角膜炎 机会性致病菌 主要是非典型分枝杆菌和 G+菌 宿主免疫功能降低及微生物的深部接种 超过半数患者可能双眼感染 药物治疗措施－－ 局部点眼，瓣下冲洗 Holmes GP. Clin Infect Dis. 2002;34:1039-1046. Pushker N. J Refract Surg. 2002;18:280-286. Garg P Ophthalmology. 2001;108:121-125. * * * * * * * Notes: Post-LASIK (laser in situ keratomileusis) keratitis is a rare occurrence.1 Opportunistic infections, especially atypical mycobacteria and Gram-positive organisms, predominate.2,3 Clustered cases are usually caused by opportunistic organisms.2 Altered host defense mechanisms as well as deep inoculation of organisms may contribute to the development of keratitis.3,4 Five cases of bilateral infection have been reported in the literature.5-6 Treatment may require flap amputation and prolonged treatment with antibiotics. References: 1. Holmes GP, Bond GB, Fader RC, et al. A cluster of cases of Mycobacterium szulgai keratitis that occurred after laser-assisted in situ keratomileusis. Clin Infect Dis. 2002;34:1039-1046. 2. Pushker N, Dada T, Sony P, et al. Microbial keratitis after laser in situ keratomileusis. J Refract Surg. 2002;18:280-286. 3. Holland E. Preventing and treating infections in refractive surgery. Rev Refract Surg. Oct 2002:48-53. 4. Giaconi J, Pham R, Ta CN. Bilateral Mycobacterium abscessus keratitis after laser in situ keratomileusis. J Cataract Refract Surg. 2002;28:887-890. 5. Suresh PS, Rootman DS. Bilateral infectious keratitis after a laser in situ keratomileusis enhancement procedure. J Cataract Refract Surg. 2002;28:720-721. 6. Garg P, Bansal AK, Sharma S, et al. Bilateral infectious keratitis after laser in situ keratomileusis: a case report and review of the literature. Ophthalmology. 2001;108:121-125. 单纯疱疹病毒性角膜炎(herpes simplex keratitis) 发病率和致盲率居角