准分子激光角膜原位磨镶术和飞秒激光小切口透镜取出术术后的泪液功能障碍

Postoperative tear dysfunction of LASIK and SMILE

泪液功能障碍被认为主要是泪膜构成的异常导致促炎因子的产生。近期的研究表明，泪膜成分的改变导致泪液功能障碍，加速眼表上皮细胞的死亡和脱落，从而导致角膜表面的不规则、泪膜不稳定和角膜神经末梢的高度敏感化。很大一部分患者在准分子激光角膜原位磨镶术（LASIK）和飞秒激光小切口透镜取出术（SMILE）后存在泪液功能障碍。本文就LASIK和SMILE术后泪液功能障碍的临床特点、泪液功能障碍潜在的发生机制以及以机制为基础的合理治疗方案进行综述。

Tear dysfunction was considered as abnormalities of tear film composition that include the presence of pro-inflammatory cytokines. Recent studies indicated that altered tear composition caused dysfunction, accelerated death and detachment of the superficial epithelium,leading to an irregular corneal surface, an unstable tear layer and hyperesthesia of the corneal nerve endings. Symptoms of tear dysfunction after laser in situ keratomileusis （LASIK） and small incision lenticule extraction （SMILE） present in many patients. This review summarized the clinical characteristics of tear dysfunction in post-LASIK and post-SMILE patients, analyzed the potential mechanism of tear dysfunction and reasonable management.