Oculus眼表综合分析仪在LASIK术前泪液功能评价中的应用

Clinical application of Oculus Keratograph5M in the evaluation of tear function before LASIK

目的探讨Oculus眼表综合分析仪在LASIK术前泪液功能评价中的有效性，并分析其测量值与传统泪液检查方法之间的相关性。方法临床病例回顾性系列研究。选取鄂州市中心医院2014年9至2015年3月，84例（84只眼）欲行角膜屈光手术的近视患者行Oculus眼表综合分析仪测量非侵人性泪膜破裂时问（NIBUT）、下泪河高度（LTMH）；SchimerI试验（Sit）测量基础泪液分泌；荧光素染色后裂隙灯钴蓝光下观察侵入性泪膜破裂时间（fl—BUT）。采用Spearman秩相关分析NIBUT、LT—MH与fl—BUT、Sit之间的关系。结果NIBUTf短于NIBUTAV，差异有统计学意义（z=-7．624，P=0．000），二者呈现良好的正相关（n=0．83，P=0．000）；NIBUTf短于fl—BUT，差异有统计学意义（z=-3．737，P=0．000），二者呈正相关（rs=0．37，P=0．001）；NIBUTAV与fl—BUT差异无统计学意义（z=-1．139，P=0．255），呈正相关（rs=0．39，P=0．000）。NIBUTf与SIT无明显相关性（rs=0．19，P=0．092），与LTMH呈弱相关（rs=0．23，P=O．033）；NIBUTA，与SIT、LTMH均呈正相关（rs=0．28，P=0．009；rs=0．30，P=0．005）；fl—BUT与SIT、LTMH均有相关性（rs=0．29，P=0．007；rs=0．30，P：0．006）；SIT与LTMH呈良好的正相关（rs=0．35，P：0．001）。结论利用Oculus眼表综合分析仪可以进行客观的NIBUT、LTMH的测量，显示泪膜分布图，其中NIBUTf与fl—BUT、LTMH均呈正相关，NIBU-Tav与fl—BUT与SIT、LTMH均呈正相关，可作为评估的LASIK术前泪液功能一种新的有效方法。

Objective To evaluate the validity of the measurement of tear function using Oculus Keratograph5M before LASIK, analyze the correlations between its measurement and tra-ditional tear function examination methods. Methods Eighty-four cases （84 eyes） were diagnosed myopia and then accepted LASIK in Ezhou Central Hospital. Non-invasive first tear film break-up time （NIBUTf）, Non-invasive average tear film break-up time （NIBUTav）, Lower tear meniscus height （LT- MH） were measured with Oculus Keratograph5M, Schirmer I test （SIT） and fluorescein tear film break-up time （fl-BUT） were performed on all cases. The correlations analysis between the measure- ment of Oculus Keratograph5M and traditional tear function examinations were performed by spear- man rank correlation. Results NIBUTf were significantly shorter than NIBUTAV （z =-7.624, P = 0.000）, but showed good positive correlation （rs=0.83, P =0.000）; NIBUTf were significantly shorter than fl-BUT （z =-3.737, P =0.000）, but showed good positive correlation （rs=0.37, P =0.001）. There was no significant difference between NIBUTAV and fl- BUT （z =-1.139, P =0.255）, but showed good positive correlation （rs=0.39, P =0.000）. There was no correlation between NIBUTf and SIT （r~= 0.19, P =0.092）, NIBUT and LTMH showed weak correlation （rs=0.23, P =0.033）; NIBUTAV and SIT, LTMH showed good positive correlation （rs=0.28, P =0.009; rs=0.30, P =0.005）; fl- BUT and SIT, LTMH showed good positive correlation also （rs=0.29, P =0.007; rs=0.30, P =0.006）. There was good positive correlation between LTMH and SIT （rs=0.35, P =0.001）. Conclusions NIBUTAV, NIBUTf, LTMH can be objectively measured by Oculus Keratograph5M and show the tear film dis- tribution; it is an effective method to the measurement of tear function before LASIK.