准分子激光原位角膜磨镶术后屈光回退的危险因素分析

Research on risk factors for refractive regression after laser in situ keratomileusis

目的探讨准分子激光原位角膜磨镶术后屈光回退的危险因素。方法 225例近视患者分别在LASIK术前以及术后6个月进行Schirmer试验、泪膜破裂时间、角膜知觉、角膜厚度和角、结膜荧光素染色检查,并接受McMonnies干眼症状问卷调查。综合病史及治疗效果对结果作比较分析。结果 LASIK术后屈光回退和预矫正屈光度、较大的切削深度以及术后的干眼症状显著相关。术后发生干眼症的32例患者8例(25％)同时伴有屈光回退,而未发生干眼症的193例患者中仅18例(9.3％)伴有屈光回退,差异有极显著意义(P＜0.01)。结论 LASIK术后干眼症患者屈光回退的危险性增加。

Objective To investigate the risk factors for refractive regression after laser in situ keratomileusis （LASIK）. Methods 225 eyes of 225 patients with myopia enrolled in this study. Examinations including Schirmer test, tear-film breakup time（ BUT）, corneal sensation, ocular surface staining, and pachymetry were performed before and 6 months after LASIK. Dry -eye symptoms were assessed using the MeMonnies Dry Eye Symptom Survey. Data were analyzed based on history and treatment response. Results The risk for regression was significantly associated with higher attempted refractive correction, greater ablation depth, and dry eye symptoms after LASIK. Regression after LASIK was related to chronic dry eye. It occurred in 8 of 32 patients with chronic dry eye and in 18 of 193 patients without（ P 〈0.01）. Conclusion The risk for refractive regression after LASIK was increased in patients with chronic dry eye.