激光虹膜切除术致复发性疱疹性角膜炎1例。

Changgeng yi xue za zhi Pub Date : 1999-09-01
S C Huang, W C Wu, R J Tsai
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引用次数: 0

摘要

疱疹性角膜炎再活化的机制尚不清楚。临床观察发现,这种再激活可能与多种内源性和外源性刺激有关,如强烈的阳光、发烧、月经和精神障碍。在实验研究中,大多数诱导复发的方法都涉及到一定程度的角膜创伤、炎症、神经元刺激或角膜神经的损伤。虽然激光虹膜切除术(LI)后的角膜损伤有很好的文献记载,但由LI引起的复发性疱疹性角膜炎从未报道过。在这里我们提出一个罕见的病例复发疱疹性角膜炎引起的LI。大疱性角膜病变的发生部位与激光虹膜切除术部位密切相关。临床结果以及抗病毒治疗的显著反应支持了这一诊断。虽然激光虹膜切除术的能量在大多数情况下是相对安全的,但也不能忽视诱发疱疹性角膜炎的可能性。因此,临床医生要注意这种潜在的并发症。
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Recurrent herpetic keratitis induced by laser iridectomy: case report.

The mechanism for herpetic keratitis reactivation remains unclear. When observed clinically, the reactivation may be associated with a variety of endogenous and exogenous stimuli, such as strong sunlight, fever, menstruation, and psychiatric disturbances. In experimental studies, most methods of inducing recurrence have involved some degree of corneal trauma, inflammation, neuronal stimulation, or damage to the nerves that innervate the cornea. Although corneal damage after laser iridectomy (LI) is well documented, recurrent herpetic keratitis induced by LI has never been reported. Here we present an unusual case of recurrent herpetic keratitis induced by LI. The location of the bullous keratopathy was strongly correlated to the site of laser iridectomy. Clinical findings as well as the dramatic response to antiviral treatment supported the diagnosis. Although the energy for laser iridectomy is relatively safe for most circumstances, the possibility of inducing herpetic keratitis cannot be ignored. Therefore it is important for clinicians to beware of this potential complication.

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