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펨토초라식수술 후 미만층판각막염과 동반하여 발생한 중심독성각막병증

Central Toxic Keratopathy after Femtosecond Laser in-situ Keratomileusis

대한안과학회지 2020년 61권 6호 p.680 ~ 684
박세영, 곽주영, 최진석, 박규홍, 정성근, 현주,
소속 상세정보
박세영 ( Park Se-Young ) - Saevit Eye Hospital
곽주영 ( Kwag Joo-Young ) - Saevit Eye Hospital
최진석 ( Choi Jin-Seok ) - Saevit Eye Hospital
박규홍 ( Pak Kyu-Hong ) - Saevit Eye Hospital
정성근 ( Chung Sung-Kun ) - Saevit Eye Hospital
현주 ( Hyun Joo ) - Saevit Eye Hospital

Abstract


Purpose: To report a case of central toxic keratopathy after femtosecond laser in-situ keratomileusis (LASIK).

Case summary: A 26-year-old male developed diffuse lamellar keratitis bilaterally on day 2 after femtosecond LASIK. He was applying topical steroid frequently, while also using topical antibiotics. On day 6 after LASIK, slit-lamp biomicroscopy showed a thick central corneal opacity on the right eye so a flap irrigation was performed. He was then treated with systemic methylprednisolone. A corneal epithelial crack and stromal striae were noted by slit-lamp biomicroscopy on postoperative day 10. Four weeks after LASIK, the refractive error was +4.25 Dsph = -1.25 Dcyl Axis 80°. He was treated with topical steroid, topical antibiotics, and oral doxycycline until eight weeks after LASIK. Eight weeks after LASIK, the patient was observed without treatment. The central corneal thickness recovered from 488 μm at eight weeks to 540 μm, and the refractive error was +1.25 Dsph = -0.75 Dcyl Axis 85° at postoperative 72 weeks. The central corneal opacity also recovered.

Conclusions: Because femtosecond LASIK may result in a combination of diffuse lamellar keratitis and central toxic keratopathy, the clinical characteristics and natural course of both diseases should be understood and timely treatment should be available.

키워드

Central toxic keratopathy; Diffuse lamellar keratitis; Laser in situ keratomileusis

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