LASIK所致的神经营养性上皮病变与角膜接触镜佩戴史的关系

The correlation between LASIK-induced neurotrophic epitheliopathy and soft corneal contact lens wearing history

目的了解准分子激光原位角膜磨镶术（LASIK）所致的神经营养性上皮病变与软性角膜接触镜佩戴史的关系。方法2006年3月～2006年7月在我院行LASIK的患者中挑选无眼睑、结膜、角膜和泪器疾病史且泪膜破裂时间BUT〉10’、泪液分泌试验Schirmer test〉10mm者共105例按软性角膜接触镜佩戴史进行分组，随防1年比较术后角膜神经营养性上皮病变的发生率，术后角膜神经营养性上皮病变病例的不适症状、体征和治愈天数。结果有5年以上软性角膜接触镜佩戴史的患者术后易发生角膜神经营养性上皮病变，角膜神经营养性上皮病变的体征较重，治愈天数较长。结论加强有角膜接触镜佩戴史患者LASIK术后随防，及时发现和治疗术后角膜神经营养性上皮病变，可提高术后用眼的舒适度，增加患者的满意度。

Objective To discuss the correlation between LASIK-induced neurotrophic epitheliopathy and soft corneal contact lens wearing history. Methods We divided 105 patients without ocular surface diseases into three groups according to their contact lens wearing history, and then statistically analyzed the incidence of LASIK-induced neurotrophic epitheliopathy after one year follow-up. Compared the symptoms,signs and healing time of cases among three groups. Results Patients with a over-five-year contact lens wearing history occured LASIK-induced neurotrophic epitheliopathy most frequently,had most serious signs and healed after longest time＇s therapy. Conclusion To increase the comfort of LASIK and enhance the patients＇ satisfaction, diagnosis and treatment of LASIK-induced neurotrophic epitheliopathy in time through enforcing follow-up about patients with a longtime contact lens wearing history is necessary .