摘要
目的 观察机械法准分子激光上皮瓣下角膜磨镶术(Epi-LASIK)后泪膜和眼表的变化,探讨其与haze及屈光回退的关系.方法 低中度近视214眼和高度近视154眼行Epi-LASIK手术,分别于术前和术后行泪膜破裂时间(BUT)、泪液分泌量(Schirmer Ⅰ试验)和角膜荧光素染色检查,并观察术后haze和屈光回退情况,对相关数据进行t检验和相关统计分析.结果 术后1个月87跟(23.6%)出现0.5级或1级haze,术后3个月69眼(18.8%),术后6个月48眼(13.0%).术后6个月37眼(10.1%)出现屈光回退.出现haze和屈光回退的病例均属于高度近视组.低中度近视组和高度近视组术后BUT值均有不同程度减小.术后1、3、6个月,高度近视组的BUT下降程度较低中度近视组明显,差异有统计学意义(t=6.82、7.51、6.73,P均<0.05).低中度近视组和高度近视组泪液分泌量术后与术前相比差异均无统计学意义,术后两组之间泪液分泌量差异亦无统计学意义.术后1、3、6个月,高度近视组角膜荧光素染色点的数量明显多于低中度近视组(t=5.48、5.23、7.67,P均<0.05).术后1、3、6个月,高度近视组中haze的发生与BUT下降幅度和角膜荧光素染色点的数量呈正相关(r=0.892、0.881,P均<0.05).术后6个月,高度近视组屈光回退眼的BUT值下降幅度较无屈光回退眼更明显,差异有统计学意义(t=5.50,P<0.05);屈光回退眼角膜荧光素染色点的数量明显多于无屈光回退眼(t=5.27,P<0.05).结论 Epi-LASIK术后泪膜和眼表变化与haze及屈光回退密切相关.
Objective To investigate the changes in tear film and ocular surface after epipolis laser in situ keratomileusis (Epi-LASIK), and to evaluate the relationship with haze and refractive regression. Methods Epi-LASIK was performed on 214 eyes with low and moderate myopia and 154 eyes with high myopia. Tear film break up time (BUT), Schirmer Ⅰ test and corneal fluorescence staining were observed before and after the operation. Corneal haze and refractive regression were also examined. The results were analyzed with t test and correlation analysis. Results Haze was found in 87 eyes (23.6%) 1 month after the operation, in 69 eyes (18.8%) 3 months after the operation, and in 48 eyes (13.0%) 6 months after the operation. Refractive regression was found in 37 eyes (10.1%) 6 months after the operation. Haze and refractive regression were only found in high myopia. The values of BUT decreased in all eyes after Epi-LASIK. There was a significant decrease in eyes with high myopia 1 month, 3 months and 6 months after the operation (t=6.82, 7.51,6.73, P〈0.05). The Schirmer Ⅰ test showed no differences when all eyes were compared before and after the operation, and there were no differences between the two groups after the operation (P〉0.05). There was more fluorescence staining on the corneas of eyes with high myopia compared to eyes with low and moderate myopia (t=5.48, 5.23, 7.67, P〈0.05). There was a positive correlation between the occurrence of haze and a decrease in the scope of BUT (r=0.892), and there was a positive correlation between the occurrence of haze and the amount of fluorescence staining on the cornea after the operation (r=0.881). There was a greater decrease in tear film stability in eyes with refractive regression 6 months after the operation (t=5.50, P〈0.05). Theamount of fluorescence staining on the cornea was also greater in eyes with refractive regression 6 months after the operation (t=5.27, P〈0.05). Conclusion The changes in tear film and the ocular surface are associated with haze and refractive regression.
出处
《中华眼视光学与视觉科学杂志》
CAS
2010年第4期286-289,共4页
Chinese Journal Of Optometry Ophthalmology And Visual Science