不同角膜瓣位置对飞秒激光术后干眼的影响

Effect of corneal flaps at different positions of the dry eye after femtosecond

目的探讨飞秒激光在同一个体制作不同方位角膜瓣与术后干眼发生率的关系。方法临床病例对照研究。对2014年8-12月在天津爱尔眼科医院将30例（60只眼）预行飞秒激光的男性近视患者，年龄18-35岁，平均（24．78±4．08）岁，按眼别分为两组：A组鼻侧瓣（30只眼），等效球镜为（-5．39±1．87）D：B组上方瓣（30只眼），等效球镜为（-5．02±1.32）D。观察同一个体双眼在术前、术后1周、1个月、3个月角膜荧光染色、泪膜破裂时间检查、SchirmerI试验的结果，应用SPSS17.0进行统计学分析。结果术前两组角膜荧光染色、BUT和SchirmerI试验比较结果差异无统计学意义（P〉0．05）；术后1周、1个月，两组比较结果差异无统计学意义（P〉0．05）；术后3个月与术前比较结果差异无统计学意义（P〉0．05）。结论就同一个体而言，飞秒激光制作角膜瓣方位的选择对术后干眼影响不大，且术后干眼恢复的时间较传统手术快。

Objective To investigate the relationship between different position femtosecond la- ser corneal flap and the incidence of postoperative dry eye in the same individual. Methods Male with myopia patients of 30 patients （60 eyes） received femtosecond laser, aged 18-35 （averaged age of 24.78±4.08）, were divided into two groups according to the left and right eye： group A of nasal flap （30 eyes）, spherical equivalent was （-5.39±1.87）D; group B of superior flap （30 eyes）, spherical equivalent was （-5.02±1.32）D. Corneal fluorescein staining, tear film break-up time check, Schirmer I test results in the same individual eyes were observed preoperative and postoperative of 1 week, 1 month, 3 months. Comparative analysis was used SPSS software. Results The preoperative corneal fluorescein staining, BUT and Schirmer I test comparison of two groups showed no signifi- cant difference （P 〉 0.05）; after 1 week, 1 month, the two groups showed no significant difference （P 〉0.05）; after 3 months compared with the preoperative results no significant difference （P 〉 0.05）. Conclusions There is no relationship between different position femtosecond laser corneal flap and the incidence of postoperative dry eye in the same individual. But recovery time of dry eye is faster on femtosecond laser than traditional surgery.