准分子激光原位角膜磨镶术术前干眼的临床调查分析

Incidence and manifestations of dry eye before LASIK surgeries

目的调查分析准分子激光原位角膜磨镶术(LASIK)术前干眼的患病情况及临床特征,指导LASIK术前用药。方法采用非干预性、观察性研究的方法。收集2013年9月至2013年10月就诊于广州军区武汉总医院眼科准分子中心拟行近视手术的患者资料,进行干眼症OSDI问卷调查和相关临床检查,包括裂隙灯检查、角膜荧光素染色(FL)、泪膜破裂时间(BUT)检查,并对临床资料进行分析。结果接受调查35例近视患者中有13例诊断为干眼,患病率37.14%(13/35)。干眼患者的不适症状依次为:畏光14例,最为多见,其次分别为眼痛12例、砂粒感10例、视物模糊8例。OSDI问卷评分(11.13±9.33)分,BUT:(4.87±2.31)s。患病率与性别和年龄的关系:女性高于男性,差异具有统计学意义(P=0.042);大于30岁者明显高于30岁以下者,差异具有统计学意义(P=0.029)。OSDI问卷分级与2013年干眼临床诊疗专家共识在评估干眼组与正常组得知差异无统计学意义(P=0.44)。屈光度数对干眼发病无影响(P=0.079)。结论 LASIK术前干眼患病率高,术前应做常规干眼检查及治疗,利于提高术后患者的舒适度及视觉质量。

Objective To investigate the prevalence and important clinical manifestations of dry eye before LASIK,and to guide the medication therapy for dry eye before LASIK. Methods This was a non-interventional observational study. We collected clinical data from 70 eyes underwent LASIK between September 2013 to October 2013 in our hospital. OSDI questionnaire was obtained from the patients. Patients also received comprehensive ophthalmic examination including slit-lamp checkup,corneal fluorescent stain test,and tear break-up time（ BUT） tests. Results Among 70 eyes,twenty-four were diagnosed with dry eyes（34. 29%）. Complains of these patients included photophobia（ n = 14）,tearing（ n = 12）,foreign body sensation（ n = 10）,and blurred vision（ n = 8）. OSDI score was 11. 13 ± 9. 33,and BUT was 4. 87 ± 2. 31 sec. The incidence of dry eye was significantly higher in females than in males（ P = 0. 042）,and higher in older patients（ 30 years） than in younger patients（ P = 0. 029）. The results of OSDI questionnaire were consistent with the dry eye criteria according to 2013 guidelines. Refractive error did not affect the incidence of dry eye. Conclusion Prevalence of dry eye was considerably high before LASIK. Careful preoperative examination and prompt treatment could improve the postoperative comfort level and visual quality.