准分子激光原位角膜磨镶术后干眼症的临床分析

Clinical Analysis of Dry Eye After Laser in Situ Keratomileusis

【目的】观察和探讨准分子激光原位角膜磨镶术(LASIK)与干眼症的相关因素。【方法】对59例(118只眼)近视患者行LASIK,观察术前、术后1周、1个月和3个月的干眼症症状、角膜荧光素染色、泪膜破裂时间(BUT)和泪液分泌试验的变化。【结果】①术后1个月,3个月症状的自我评分与术前比无明显差异(均P>0.05);②术后3个月角膜荧光素染色结果与术前比无明显差异(P>0.05);③术后1周、1个月、3个月BUT较术前明显缩短,差异有显著性(P<0.05);④术后1周、1个月、3个月泪液分泌试验与术前相比明显缩短,差异有显著性(P<0.05)。【结论】①干眼症是LASIK术后普遍存在的并发症之一。②术后角膜荧光素染色、BUT、泪液分泌试验等的检查可出现异常的改变,其发生机制与患者自身情况、手术方法、手术操作及术后用药等多种因素有关。③LASIK术后干眼症最终可随着时间推移而逐渐缓解或痊愈。

[Objectivo]To investigate the relations between laser in situ keratomileusis （LASIK）and dry eye. [Methods]The prospective study involved 59 patients （118 eyes） who underwent bilateral LASIK for the correction of myopia. Symptoms of dry eye.fluorescein stainings, tear break-up times（BUT） and Schirmer Ib Test values were recorded preoperatively and postoperatively in the first week, the first month and the third month. [Results]①There existed obvious difference （ P 〈0.05） in symptoms of dry eye in the first week postoperatively compared with the preoperative level while no such obvious difference （ P 〉0.05） existed in symptoms of dry eye in 1 month,and 3 months postoperatively compared with the preoperative level. ②There was obvious increase in fluorescein staining in 1 week and 1 month postoperatively compared with the preoperative level （ P 〈0.05）, but without distinct difference （ P 〉0.05） in 3 months postoperatively compared with the preoperative level. ③There was significant difference （ P 〈0.05） in BUT between preoperation and post- operation in 1 week, 1 month and 3 months. ④The times of the Schirmer Ib Test result were shorter in 1 week, 1 month, 3 months （ P 〈0.05） after LASIK than preoperation. [Conclusion]There are obvious changes in the symptoms of dry eye, fluoresccin staining, BUT and Schirmer Ib Test after LASIK. They are related with various factors, but patients can alleviate and recover with time.