不同程度近视小切口飞秒激光基质透镜取出术后干眼状况研究

Dry eye after small incision femtosecond laser lenticule extraction in different degrees of myopia

干眼是屈光手术最常见的并发症之一。小切口飞秒激光基质透镜取出术(small incision lenticule extraction,SMILE)与其他屈光术式相比,干眼的发生率最低。但不同程度近视患者SMILE术后干眼发生率不同且相关影响因素可能也存在差异。近视程度越高,SMILE手术去神经的增加导致角膜感觉神经纤维释放P物质和降钙素基因相关肽增加,引起神经源性炎症的发生增加,干眼症状越重;与干眼相关的检查,如角膜染色、Schirmer试验、泪膜破裂时间、泪液渗透压、角膜敏感性和眼表疾病指数评分等异常程度越严重。

Dry eyes is one of the most common complications after laser vision correction.Although small incision lenticule extraction(SMILE)has the lowest incidence of dry eye compared with other refractive procedures.The prevalence of dry eye in patients with different degrees of myopia after SMILE is different,and the related influencing factors may also be different.The higher the degree of myopia,the more denervation caused by SMILE surgery leads to the increased release of substance P(SP)and calcitonin gene-related peptide(CGRP)from corneal sensory nerve fibers,the increased occurrence of neurogenic inflammation and the severer dry eye symptoms.Dry eye related examinations such as corneal staining,Schirmer test,tear film break-up time,tear osmolality,corneal sensitivity and ocular surface disease index score were more abnormal.