RK术后欠矫的LASIK治疗对泪膜的影响

The changes in tear film after LASIK for the remained myopia after radial keratotomy

目的了解RK术后欠矫的患者经LASIK手术后的泪膜稳定性的改变。方法对16例(21眼)RK术后残留近视患者行LASIK治疗,分别在术前、术后1天、1周、1个月、3个月及半年时询问干眼症状并进行荧光素试验、孟加拉玫瑰红染色和泪膜破裂时间(BUT)、泪液分泌量测定,对数据进行统计分析。结果干涩感:术后1周时,术眼干涩感明显加重,差异有显著意义;异物感:术后1天、1周时术眼异物感显著加重;灼烧感:术后1天、1周时术眼灼烧感比术前明显加重,有显著差异。荧光素染色:术后1天、1周、1个月时,术眼角膜荧光素着色较术前显著增多,术后3个月和6个月与术前比无显著差异;虎红染色:与术前比,术后1天、1周、1个月时,术眼虎红着色点明显增多,有显著差异,术后3个月和6个月则无显著差异。BUT:与术前比较,术后1天、1周及1个月时,BUT显著缩短,术后3个月和6个月时较接近术前水平,无显著差异。术后1天,泪液分泌量增加,有显著意义,其余各个时间点泪液分泌量均下降,仅在1周、1个月时差异有显著性。结论RK术后欠矫患者接受LASIK治疗对泪膜有一定程度的影响,但可在术后1个月后基本恢复到术前水平。

Objective To investigate the changes in tear film after LASIK for the remained myopia after redial keratotomy. Methods LASIK was performed on the 16 cases(21 eyes) with remained myopia after radial keratotomy. The eyes were observed for subjective complaints of dry eye, fluorescein staining(F1), rose Bengal staining(Rb), tear break-up time(BUT), Schirmer's I test preoperatively and 1 day, 1 week, 1 month, 3 months, 6 months postoeratively. Results The subjective complaints of dry eye were more sever postoeratively. F1 and Rb staining dots were more concentrated at 1 day, 1 week, 1 month postoeratively(p<0.05). No significant changes were found in F1 and Rb staining at 3 months and 6 months postoeratively(p>0.05). There were obvious decreas in BUT at 1 day, 1 week, 1 month postoeratively relative to the preoperative level(p<0.05). The Schirmer's 1 test result was higher at 1 day with statistical significance(p<0.05), but lower at 1 week and 1 month after LASIK. No significant changes were observed in Schirmer's I test at 3 months and 6 months postoeratively (p<0.05). Conclusion LASIK have some effects on tear film.