SBK对高度近视患者泪液功能及视力的影响

Effect of Sub-bowman Keratomileusis on tear function and vision of patients with high myopia

目的分析前弹力层下准分子激光原位磨镶术(SBK)对高度近视患者泪液功能及视力的影响。方法本院2017年6月至2022年6月收治的60例高度近视患者分为进行准分子激光上皮角膜磨镶术(LASEK)治疗的对照组和进行SBK治疗的观察组,均每组30例(60眼),分组方法为随机抽签法,两组术后均观察12个月。比较两组泪液功能、视网膜厚度(RT)、角膜前表面像差、视力。结果对照组术前及术后1、3个月平均泪膜破裂时间(BUT)呈先缩短后延长趋势,术后6个月长于术后1个月(P<0.05);观察组术前及术后3、6个月平均BUT均长于术后1个月(P<0.05);观察组术后1、3个月平均BUT长于对照组(P<0.05)。两组整体RT术后1个月与术前比较,升高,观察组高于对照组(P<0.05)。观察组术后1、3个月总高阶像差均方根、四阶球差低于对照组(P<0.05)。观察组术后1、3、6个月视力高于对照组(P<0.05)。结论SBK治疗高度近视对患者总高阶像差均方根、四阶球差影响较小,有助于患者整体RT的改善,且术后患者泪液功能和视力恢复更快。

Objective To analyze the effect of Sub-bowman Keratomileusis(SBK)on tear function and vision of patients with high myopia.Methods From June 2017~June 2022,60 patients with high myopia in our hospital were divided into the control group treated with laser-assisted subepithelial keratomileusis(LASEK)and the observation group treated with SBK,with 30 cases(60 eyes)in each group.The grouping method was random lottery,and both groups were observed for 12 months after operation.The tear function,retinal thickness(RT),corneal anterior surface aberration and visual acuity were compared between the two groups.Results In the control group,the average break up time(BUT)was shortened at first and then extended at 1 and 3 months after operation,and it was longer at 6 months after operation than at 1 month after operation(P<0.05).In the observation group,the average BUT before operation and 1 and 3 months after operation was longer than 1 month after operation(P<0.05).The average BUT in the observation group was longer than that in the control group 3 and 6 months after operation(P<0.05).The overall RT of the two groups increased 1 month after operation compared with that before operation,and the observation group was higher than the control group(P<0.05).The root mean square of total higher-order aberrations and fourth-order spherical aberration in the observation group were lower than those in the control group 1 and 3 months after operation(P<0.05).The visual acuity of the observation group was higher than that of the control group 1,3 and 6 months after operation(P<0.05).Conclusion The treatment of high myopia with SBK had little effect on the root mean square of total higher-order aberrations and the fourth-order spherical aberration of patients,which was helpful to improve the overall RT of patients,and the tear function and visual acuity of patients recover faster after operation.