非球面切削准分子激光原位角膜磨镶术后泪膜改变的研究

Changes in the tear film after LASIK with aspheric ablation

目的:观察非球面切削准分子激光原位角膜磨镶术(1aser in situ keratomileusis,LASIK)后泪液分泌、泪膜的变化,探讨其与干眼的关系。方法:对80名近视眼患者实施双眼LASIK非球面切削手术,分别用SchirmerⅠ试验(基础分泌试验)和荧光素染色测定患者术前、术后1周、1个月、3个月、6个月的泪液分泌值和泪膜破裂时间(break up time,BUT)。结果:(1)BUT值(单位:秒):术前为20.07±5.90,术后1周、1个月、3个月、6个月分别为8.47±2.64、10.51±2.63、13.29±2.74、19.85±5.75,术后1周、1个月、3个月分别与术前的BUT值比较,差异均有显著性意义(P<0.01),术后6个月BUT值与术前比较无显著性差异(P>0.05)。Schirmer值(单位:mm):术前为16.24±6.68,术后1周、1个月、3个月、6个月分别为12.86±6.14、14.65±9.92、15.38±6.27、16.18±5.77,术后1周、1个月和3个月Schirmer值分别与术前比较,差异有统计学意义(P<0.05),而术后6个月Schirmer值与术前比较差异无统计学意义(P>0.05)。结论:LASIK非球面切削术后3个月内泪膜稳定性下降及泪液分泌减少,术后6个月泪膜稳定性和泪液分泌恢复术前水平。

Objective To investigate the changes in tear secretion and tear film stability after LASIK with aspheric ablation. Methods 80 myopic patients received LASIK with aspheric ablation. The values of tear secretion and tear film break-up time （BUT） were measured by Schirmer′s test and fluorescent staining preoperatively and 1 week and 1, 3, and 6 months after the surgery. Results As compared with the baseline, the mean BUT differed significantly 1 week and 1 and 3 months after the procedure （20.07 ± 5.90 vs. 8.47 ± 2.64, 10.51 ± 2.63, and 13.29 ± 2.74, respectively; P 0.01） but did not differ significantly 6 months after the procedure （20.07 ± 5.90 vs. 19.85 ± 5.75, P 0.05）; an the mean value of Schirmer′s test differed significantly 1 week and 1 and 3 months after the procedure （16.24 ± 6.68 vs. 12.86 ± 6.14, 14.65 ± 9.92, and 15.38 ± 6.27, respectively; P 0.05） but did not differ 6 months after the procedure （16.24 ± 6.68 vs. 16.18 ± 5.77, P 0.05）. Conclusions Both tear film stability and tear secretion decrease within 3 month after LASIK with aspheric ablation and then return to the baseline levels 6 months after the procedure.