准分子激光术后角膜上皮基底膜下神经分布及形态学特征

Distribution and morphological changes of subbasal nerve fiber after different excimer laser operation.

目的观察准分子激光原位角膜磨镶术(LASIK)和准分子激光上皮下角膜磨镶术(LASEK)术后角膜上皮基底膜下神经分布及形态学特征。方法共焦显微镜观察低、中度近视LASIK及LASEK27例(54眼),术前、术后1、3、6月的角膜上皮基底膜下神经纤维分布和形态学特征,并测定泪膜破裂时间(BUT)和泪液分泌量(SchirmerI值)。结果LASIK(12例,24眼)与LASEK(15例,30眼)术后角膜上皮基底膜下神经纤维的再生和形态学在各时间点差异均无统计学意义。两组中BUT有统计学意义(P<0.05)而SchirmerI值无统计学意义(P>0.05)。结论对于低、中度近视而言,LASIK与LASEK术后角膜上皮基底膜下神经纤维的再生未显示形态学上的差异。

Objective To observe subbasal nerve distribution and morphological changes after laser-assisted in situ keratomileusis （LASIK） and laser epithelial keratomileusis （LASEK）. Methods 54 eyes （ 27 myopic patients） of less than 6 diopters （D） had slit-scanning confocal microscopy and examined tear film break up time （BUT） and Schirmer value preoperatively and 1,3, and 6 months after surgery. Results Corneal subbasal nerve fiber density, nerve branch density , nerve fiber length decreased significantly 1 month after LASIK. Nerve fiber morphology was not different between the 24 eyes （12 patients） that had received LASIK and 30 eyes （15 patients ） that had received LASEK at any visit. The mean BUT between two groups was significantly different, while there was no significant changes in Schirmer test results. Conclusion The subbasal nerves of LASIK and LASEK patients for the correction less than 6 diopters （D） of myopia were not different in morphology.