炎症性肠病(IBD)是一种慢性全身性炎症性疾病,可能会对接受选择性眼科手术的患者的手术结果产生不利影响。在这个系列中,11例溃疡性结肠炎或克罗恩病患者的21只眼行激光原位角膜磨镶术(LASIK),屈光性角膜切除术(PRK),或小切口微透镜提取(SMILE)。术后随访平均8.9±4.6个月。这项研究中的所有患者都做得很好,到术后3个月,100%的眼睛矫正远距视力达到未矫正的远距视力20/20。术后期间注意到的常见症状包括干眼症,刺激,异物感,和模糊的视力,所有这些在随访期间的患病率和严重程度都有所改善,没有一个病人经历了他们的疾病发作。尽管这些患者取得了成功的结果,作者认识到IBD患者手术的固有风险.目前,临床医生没有一致的指导方针,以确保他们充分筛查这些患者的资格,所以作者建议一个相关的,集中审查系统,一份简短的IBD病史相关问卷,以及用于手术评估的初步手术决策流程图。
Inflammatory bowel disease (IBD) is a chronic systemic inflammatory condition that can potentially adversely affect surgical outcomes in patients receiving elective ophthalmic procedures. In this case series, 21 eyes of 11 patients with ulcerative colitis or Crohn\'s disease underwent laser in situ keratomileusis (
LASIK), photorefractive keratectomy (PRK), or small incision lenticule extraction (SMILE). Their surgical outcomes were followed up for an average of 8.9 ± 4.6 months. All the patients in this study did well, with 100% of eyes corrected for distance vision achieving uncorrected distance visual acuity 20/20 by postoperative month three. Common symptoms noted during the postoperative period included dry eyes, irritation, foreign body sensation, and blurry vision, all of which improved in prevalence and severity over the follow-up period, and none of the patients experienced a flare-up of their disease. Despite the successful outcomes in these patients, the authors recognize the inherent risks of operating on patients with IBD. Currently, there are no
consensus guidelines for clinicians to follow to ensure that they are adequately screening these patients for eligibility, so the authors are suggesting a relevant, focused review of systems, a brief IBD history-related questionnaire, and a preliminary surgical decision-making flowchart for use in surgical evaluation.