飞秒激光小切口角膜基质透镜取出术对不同程度近视患者术后干眼症发生率的影响

Effect of Femtosecond Laser Small Incision Lenticule Extraction on the Incidence of Postoperative Xerophthalmia in Patients with Different Degrees of Myopia

目的:探究飞秒激光小切口角膜基质透镜取出术(SMILE)对不同程度近视患者术后干眼症发生率的影响。方法:选择2018年1月—2020年6月在攀枝花学院附属医院眼科行SMILE治疗的90例近视患者,根据近视程度分为A组(低度近视)、B组(中度近视)、C组(高度近视),各30例(60眼)。对比三组干眼症发生率、泪液分泌实验(SchirmerⅠ试验)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)、眼表疾病指数(OSDI)。结果:术后1周、1个月、3个月、6个月,C组干眼症发生率高于A组、B组,差异有统计学意义(P<0.05)。术后1周、1个月,三组SchirmerⅠ试验结果低于术前,且A组、B组高于C组,差异有统计学意义(P<0.05);术后3个月、6个月,C组SchirmerⅠ试验结果低于术前,且低于A组、B组,差异有统计学意义(P<0.05)。术后1周、1个月、3个月,三组BUT均低于术前,且C组低于A组、B组,差异有统计学意义(P<0.05);术后6个月,三组的BUT比较,差异无统计学意义(P>0.05)。术后1周、1个月,三组FL评分均高于术前,且C组FL评分高于A组、B组,差异有统计学意义(P<0.05);术后3个月、6个月,三组FL评分均低于术前,差异有统计学意义(P<0.05),但三组间FL评分比较,差异无统计学意义(P>0.05)。术后1周、1个月、3个月,三组OSDI评分均高于术前,差异有统计学意义(P<0.05);术后1周、1个月、3个月、6个月,三组组间OSDI评分比较,差异无统计学意义(P>0.05)。结论:高度近视患者SMILE术后干眼症发生率高于中度近视、低度近视患者,度数越高干眼症状越严重。

Objective:To explore the effect of femtosecond laser small incision lenticule extraction(SMILE)on the incidence of postoperative xerophthalmia in patients with different degrees of myopia.Method:A total of 90 myopia patients who underwent SMILE treatment in the Ophthalmology Department of the Panzhihua University Affiliated Hospital from January 2018 to June 2020 were selected and divided into group A(low myopia),group B(moderate myopia)and group C(high myopia)according to the degree of myopia,with 30 cases(60 eyes)in each group.The incidence of xerophthalmia,tear secretion test(SchirmerⅠtest),tear film break-up time(BUT),corneal fluorescein staining(FL)and ocular surface disease index(OSDI)were compared among the three groups.Result:At 1 week,1 month,3 months and 6 months after surgery,the incidence of xerophthalmia in group C was higher than that in group A and group B,and the difference was statistically significant(P<0.05).At 1 week and 1 month after surgery,the results of SchirmerⅠtest in three groups were lower than those before surgery,and those in group A and group B were higher than those in group C,the differences were statistically significant(P<0.05).At 3 months and 6 months after surgery,the results of SchirmerⅠtest in group C were lower than those before surgery,and lower than those in group A and group B,the differences were statistically significant(P<0.05).At 1 week,1 month and 3 months after surgery,the BUT in three groups were lower than those before surgery,and those in group C were lower than those in group A and group B,the differences were statistically significant(P<0.05).At 6 months after surgery,there was no significant difference in BUT between the three groups(P>0.05).At 1 week and 1 month after surgery,FL score in three groups were higher than those before surgery,and FL score in group C were higher than those in group A and group B,the differences were statistically significant(P<0.05).At 3 months and 6 months after surgery,FL scores of the three groups were lower than those before surgery,the differences were statistically significant(P<0.05),but there was no significant difference in FL scores among the three groups(P>0.05).At 1 week,1 month,3 months after surgery,the OSDI scores of the three groups were higher than those before surgery,and the differences were statistically significant(P<0.05).At 1 week,1 month,3 months and 6 months after surgery,there were no significant differences in OSDI scores among the three Chinese and Foreign Medical Research Vol.22,No.16 June,2024 groups(P>0.05).Conclusion:The incidence of xerophthalmia after SMILE in patients with high myopia is higher than that in patients with moderate myopia and low myopia,and the higher the degree,the more severe the symptoms of xerophthalmia.