角膜屈光术后干眼症发病情况和病因的研究进展

Research progress on the prevalence and pathogen of dry eye syndrome after corneal refractive surgery

随着角膜屈光手术技术的不断进步与完善,角膜屈光手术治疗近视的安全性、稳定性、有效性和可预测性已在临床实践的过程中得到广泛验证。机械刀制瓣的准分子角膜原位磨镶术(laser in situ keratomileusis,LASIK)、特制角膜上皮刀制瓣的准分子激光机械法上皮瓣下角膜磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)、飞秒激光制瓣的准分子角膜原位磨镶术(femtosecond laser in situ keratomileusis,FS-LASIK)、小切口飞秒激光基质透镜取出术(small incision lenticule extraction,SMILE)是目前治疗近视的主流手术方式。尤其是SMILE手术以其切口小、微创、术后干眼症状轻,已逐渐被广大中青年人所接受。而干眼症是角膜屈光术后早期常见的并发症之一,往往影响术后效果,因此受到患者和手术医生的广泛关注。通过大量的临床及实验研究发现:术前眼表的基本状态、术中术后药物的使用、手术方法的选择及操作、术后角膜损伤及恢复情况等均是影响干眼发病的重要因素。本文就角膜屈光术后干眼影响因素及发病情况作一综述。

Because of the rapid improving of corneal refractive surgery with laser,its characteristics such as safety,stability,availability and predictability have already been proved by clinical practice.Laser in situ keratomileusis（LASIK）,epipolis laser in situ keratomileusis（Epi-LASIK）,femtosecond laser in situ keratomileusis（FSLASIK） and small incision lenticule extraction（SMILE）are the main operational methods.SMILE has gradually been being accepted by young and middle-aged with its minimal invasive and little post-surgery complications.Dry eye syndrome is one of the most common complications that may affect the visual effect of the surgery.Specialists and patients have paid more attention to dry eye disease after corneal refractive surgery.According to clinical and experimental researches,the basic condition of ocular surface before surgery,the application of drugs in or after the surgery,the type of refractive surgery that operator choose,as well as the damage and reinnervation of corneal nerve all play important roles in post- surgery dry eye.This article reviews the pathogen of dry eye disease after surgery and the prevalence of dry eye after surgery.