作为 COVID-19 疫苗接种并发症的 LASIK 术后腺病毒角结膜炎:一例临床病例

A. Babushkin, G. Israfilova, G. R. Saitova, R. I. Khikmatullin
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摘要

在大规模接种冠状病毒感染疫苗期间,研究疫苗接种后可能出现的副作用具有重要的实用价值。我们介绍了一例罕见的 COVID-19 疫苗预防性并发症临床病例。一名 40 岁的女性患者被诊断为双侧腺病毒性角膜结膜炎,在接受了 LASIK 屈光手术和随后(5 天后)使用 Gam-COVID-Vac 疫苗进行免疫预防后,因左眼不自主摩擦导致角膜瓣移位而并发角膜糜烂和虹膜炎。角膜瓣被紧急复位;使用绷带软性隐形眼镜实现了角膜瓣的粘合和稳定。经过及时的局部和全身抗炎及抗病毒治疗后,患者的视力恢复到了正常水平(1.0)。眼科医生需要时刻警惕免疫预防后可能对眼部,特别是结膜和角膜造成的不良影响。及时诊断和治疗对于防止出现持续性角膜混浊等降低视力的并发症非常重要,尤其是对于接受过旨在获得尽可能高视力的屈光手术的患者。我们认为,最好在屈光手术后至少 1 个月进行疫苗接种。
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Adenovirus keratoconjunctivitis after LASIK as a complication of COVID-19 vaccination: a clinical case
During large-scale vaccination against coronavirus infection, studying possible side effects after the introduction of the vaccine is of great practical value. We present a rare clinical case of a complication of COVID-19 vaccine prophylaxis. A 40-year-old female patient was diagnosed with a bilateral adenoviral keratoconjunctivitis complicated by corneal erosion and iritis after a LASIK refractive intervention and a subsequent (after 5 days) immunoprophylaxis with the Gam-COVID-Vac vaccine followed by a displacement of the corneal flap due to involuntary friction of the left eye. The corneal flap was urgently repositioned; its adhesion and stabilization were achieved usinga bandage soft contact lens. The timely local and systemic anti-inflammatory and antiviral therapy allowed achieving a successful visual result (1.0). Ophthalmologists need to remain vigilant about possible adverse effects after immunoprophylaxis on the part of the eye, specifically the conjunctiva and cornea. A timely diagnosis and treatment are important to prevent complications such as persistent corneal opacities that reduce visual acuity, especially in patients who have undergone refractive surgery aimed at achieving the highest possible vision. In our opinion, it is advisable to perform vaccination at least 1 month after the refractive surgery.
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