LASIK术后泪液稳定性及功能性视力的研究

Study of tear function and functional visual acuity after LASIK

目的:研究LASIK手术后泪液稳定性及功能性视力的变化。方法:我们对2008-04/06在我院接受LASIK治疗近视的48例患者(96眼)进行前瞻性病例对照研究,分别在术前、术后1d;1wk;1,3,6mo进行干眼症状问卷调查,检测泪膜破裂时间(tear break-up time,BUT)、泪液分泌试验(schimer test values,STV)、角结膜荧光素钠染色(sodium fluorescein,FL)、比较功能性视力(functional visual acuity,FVA)与基础视力(baseline VA)的差值(FVA)。结果:术前有15眼(16%)有干眼症状,术后分别有91眼(95%),82眼(85%),57眼(59%),43眼(45%),32眼(33%)在术后1d;1wk;1,3,6mo表现有干眼症状;术后第1dBUT由术前7.06±2.04s缩短至4.4±1.8s(t=2.65,P=0.00),STⅠ由术前12.7±6.6mm增加到14.5±6.6mm(t=1.76,P=0.036),STⅡ由术前7.2±2.4mm减少到5.47±2.02mm(t=1.68,P=0.00),术前FL评分1.0±0.8,术后1d增多到1.4±1.0(t=0.375,P=0.002)。术后6mo除STⅠ10.6±7.0mm,仍低于术前(t=1.83,P=0.03),其余参数均恢复至术前水平。FVA术后1d由术前0.50±0.37增加至0.62±0.35(t=1.146,P=0.025),1wk后恢复至术前水平。结论:本研究证实术后干眼是LASIK矫正近视的常见并发症,主要影响BUT,STⅠ,STⅡ。LASIK术后早期功能性视力有所下降,1wk后逐渐好转。

AIM：To investigate the change of tear function and functional visual acuity（FVA） after LASIK.·METHODS：Forty-eight consecutive patients（96 eyes） who underwent LASIK for the correction of myopia were investigated.Dry eye symptoms,tear break-up time（BUT）,Schirmer test values（STV）,and corneal sodium fluorescein（FL）,staining were measured before surgery and 1 day,1 week,1 month,3 months and 6 months after surgery.The difference of FVA and baseline visual acuity（baseline VA） were also compared（FVA＇）.·RESULTS：Before surgery,16% of patients（15/96） had dry eye symptoms.After surgery,95% of patients（91/96）,85% of patients（82/96）,59% of patients（57/96）,45% of patients（43/96）,and 33% of patients（32/96） experienced dry eye symptoms at 1 day,1 week,1 month,3 months,and 6 months,respectively.One day after operation,BUT（7.06±2.04s） shortened to（4.4±1.8s;t=2.65,P=0.00）.STⅠ（12.7±6.6mm） increased to（14.5±6.6mm;t=1.76,P=0.036）.STⅡ（7.2±2.4mm） decreased to（5.47±2.02mm;t=1.68,P=0.00）.The score of FL（1.0±0.8） increased to（1.4±1.0;t=0.375,P=0.002）.All the parameters recovered at the 6th month after operation,except for STⅠ（10.6±7.0mm;t=1.83,P=0.03） which was still lower than that of the preoperative.FVA＇ increased from 0.50±0.37 to 0.62±0.35（t=1.146,P=0.025） 1 day postoperatively and recovered 1 week after operation.·CONCLUSION：Dry eye symptoms are common complications after myopic LASIK surgery.LASIK can significantly alter the BUT,STⅠand ST Ⅱ.Patients may experience a transient decrease in FVA that returns to baseline within 1 week.