LASIK术后干眼症和泪膜破裂时间的观察与护理

Nursing care of dry eye syndrome after LASIK

目的探讨准分子激光原位角膜磨镶术(LASIK)后的干眼症状和泪膜破裂时间(BUT),采取相应的护理措施。方法选择双眼屈光度相近的近视患者168例,随机将左右眼角膜瓣蒂部置于角膜上方或颞侧,再进行常规LASIK手术。分别在术前、术后1周、1月、及3月时询问干眼症状,检测泪膜破裂时间。结果干涩感:在术后1周时,上方蒂组的干涩感明显严重于颞侧蒂组,差异有显著性(P<0.01)。异物感:两组间在术后1周和1月时存在显著性差异(P<0.05)。灼烧感:两组间在术后1周时存在显著性差异(P=0.025)。泪膜破裂时间:在术后所有时间点组间均存在显著性差异(P<0.01)。结论颞侧蒂角膜瓣可保持较高的角膜敏感度,部分缓解干眼症。术后加强护理,可促进手术取得最佳效果。

Objective To investigate the nursing care of dry eye syndrome after laser - assisted in - situ keratomileusis （LASIK）. Methods One hundred and sixty - eight patients （336 eyes） with similar myopic degree of two eyes underwent bilateral LASIK with superior - hinge flap （ Group Ⅰ ） in one eye and temporal- hinge flap（ Group Ⅱ） in the other randomly. Subjective complaints of dry eye were evaluated and breakup time of tear film （BUT） was tested at baseline and 1 week, 1 month and 3 months after operation. Results Dry eye sensation, foreign body sensation and burning sensation of Group Ⅰ patients were significantiy more serious than Group Ⅱ patients at 1 week postoperativeiy（ P 〈 0.05 ） ; At 1 month postoperativeiy oniy foreign body sensation was significantiy different between two groups （ P 〈0.05 ） ; But there were no significant differences in dry eye symptom between two groups at 3 month postoperativeiy （ P 〉0.05）. BUT of Group Ⅰ patients was shorter than Group Ⅱ patients in all time points tested after LASIK （ P 〈 0.01 ）. Conclusion LASIK with temporal - hinge corneal flap can maintain higher corneal sensitivity, partial alieviate dry eye symptom. Intensive nursing care can improve the efficacy of LASIK.