■角膜胶原交联(CXL)和屈光性角膜切削术(PRK)联合手术(CXLPlus)后,明显的角膜扁平化和浑浊是重要的并发症。
■我们介绍了一名24岁的男性,他接受了标准CXL和PRK的联合治疗。患者在手术后大约4年经历了令人满意的视力。然而,在这段时间之后,他开始抱怨视觉模糊。随后的检查显示明显的角膜雾霾,双眼过度扁平化,和变薄(右眼的最薄点227μm,左眼244μm)术后4年。在介绍时,右眼矫正视力(CDVA)为20/200,左眼为20/400.呈现的屈光度为+2.50sph,右眼-3.50cyl*114和+11.5sph,左眼-9.75cyl*81。使用刚性透气隐形眼镜,双眼矫正视力为20/50。在CXLPlus手术前,右眼的初始屈光度和CDVA为20/50(-5.50sph,-3.00cyl*175)和左眼20/30(-5.50sph,-2.75卢比*175)。患者接受穿透性角膜移植术治疗。最终随访时CDVA达到20/30。
■我们的报告强调了CXL和PRK联合治疗4年后发生的严重角膜混浊和扁平化。这些发现表明,在可疑的圆锥角膜患者中,这种手术可能不安全。需要进一步的长期随访研究来评估CXL和PRK联合手术的安全性。
UNASSIGNED: Significant corneal flattening and haze are important complications that can occur after combined corneal collagen cross-linking (CXL) and photorefractive keratectomy (PRK) procedures (CXL Plus).
UNASSIGNED: We present a 24-year-old man who underwent combined standard CXL and PRK. The patient experienced satisfactory vision for approximately 4 years after the surgery. However, after this period, he began to complain of visual blurring. Subsequent examination revealed significant corneal haze, excessive flattening in both eyes, and thinning (thinnest point 227 μm in the right eye, 244 μm in the left eye) 4 years postoperatively. Upon presentation, the corrected distance visual acuity (CDVA) was 20/200 in the right eye and 20/400 in the left eye. The presenting refraction was +2.50 sph, -3.50 cyl *114 in the right eye and +11.5 sph, -9.75 cyl *81 in the left eye. With rigid gas permeable contact lenses, the corrected visual acuity was 20/50 in both eyes. Before the CXL Plus surgery, initial refraction and CDVA were 20/50 in the right eye (-5.50 sph, -3.00 cyl *175) and 20/30 in the left eye (-5.50 sph, -2.75 cyl *175). The patient was treated by penetrating keratoplasty. The CDVA reached 20/30 at the final follow-up.
UNASSIGNED: Our report highlights significant corneal haze and flattening that occurred 4 years after combined CXL and PRK treatment. These findings suggest that this procedure might not be safe in suspected patients of keratoconus. Further long-term follow-up research is necessary to evaluate the safety of combined CXL and PRK procedures.