表层角膜屈光手术后疼痛及角膜刺激症状的观察

目的 探讨表层角膜屈光手术不同手术方式术后疼痛以及角膜刺激症状的差异.方法 选取行表层角膜屈光手术的近视患者600例(1 200眼),根据不同手术方式分为准分子激光屈光性角膜切削术(PRK)组、乙醇法准分子激光上皮瓣下角膜磨镶术(LASEK)组和微型上皮刀法准分子激光上皮瓣下角膜磨镶术(Epi-LASIK)组,比较三组之间的疼痛指数以及角膜刺激症状.结果 术后第1天,PRK组与LASEK组疼痛指数及角膜刺激症状差异无统计学意义,Epi-LASIK组与其余两组差异有统计学意义.术后第2天、第3天,PRK组与其余两组相比差异有统计学意义,LASEK组与Epi-LASIK组相比差异无统计学意义.术后第5天三组之间疼痛指数以及角膜刺激症状差异均无统计学意义.结论 表层角膜屈光手术后疼痛是导致患者术后不适的主要因素.手术方式不同,患者术后的疼痛指数以及角膜刺激症状存在差异.

Postoperative pain and corneal irritation after surface corneal refractive surgery

Objective To investigate the postoperative pain and corneal irritation after superficial corneal refractive surgery by different surgical procedures. Methods A total of 600 cases (1 200 eyes) of surface corneal refractive surgery were divided into 3 groups according to different operation methods as photorefractive keratectomy group (PRK group), laser epithelial keratomileusis group (LASEK group) and epipolis laser in-situ keratomileusis group (Epi-LASIK group). The pain index and corneal irritation among the three groups were compared. Results On day 1 after surgery, there was no statistical difference in the pain index and corneal irritation between PRK group and LASEK group, but there was statistical difference between Epi-LASIK group and the other two groups. On day 2 and 3 postoperatively, there was statistical difference between the PRK group and the other two groups, but there was no statistical difference between LASEK group and Epi-LASIK group. One day 5 after surgery, there was no difference among the three groups. Conclusion The pain after surface corneal refractive surgery is the major factor of postoperative discomfort for patients. Postoperative pain index and corneal irritation are different for different operation methods.