可吸收泪点栓对术前伴干眼症患者LASIK术后的疗效观察

目的探讨可吸收泪点栓治疗准分子激光原位角膜磨镶术（LASIK）前伴干眼症患者的效果。方法前瞻性随机双肓对照研究。选取行LASIK术治疗，术前伴轻、中度干眼症的患者41例，同一患者的两眼随机分组，一眼采用可吸收泪点栓结合药物治疗（试验组），另一眼采用单纯药物治疗（对照组）。记录泪点栓的并发症，比较两眼LASIK术前，术后1周和1、3、6个月时泪液分泌试验（SIT）、角膜荧光素染色（FL）、泪膜破裂时间（BUT）和眼表疾病评分（OSDI）的值。运用两相关样本的非参数检验方法（Two Related SamplesTest）进行数据分析。结果除1例患者术后第1天泪点栓脱落外，未见其他并发症。术后1周，试验组的SIT值高于对照组，差异有统计学意义（Z=-2．005，P=0．045），术后1个月及以后，两组的SIT值趋于一致。术后1周、1个月和3个月，试验组的FL值均低于对照组，差异有统计学意义（Z=-2．124、-2．009、-2．120，P〈0．05）。而两组的OSDI和BUT值在上述各时间点差异均没有统计学意义。结论可吸收泪点栓是治疗LASIK术前伴干眼症患者的安全有效的方法。

Effect of an absorbable punctal plug in the treatment of preoperative dry eye after laser in situ keratomileusis

Objective To evaluate the efficacy of using an absorbable punctal plug in the treatment of preoperative dry eye after laser in situ keratomileusis （LASIK）. Methods This was a prospective, randomized, double-blind study. Forty-one consecutive patients with mild to moderate dye eye were included. Absorbable punctal plugs were randomly implanted in one eye of each patient. Fluorescent staining （FL）, break-up time （BUT）, Sehirmer I test （SIT） and ocular surface disease index （OSDI） grading were performed befbre and 1 week and 1, 3, and 6 months after LASIK. Results No complications were observed except plug extrusion in one ease. FL staining was significantly lower in the treated eyes compared to control eyes at 1 week （Z=-2.124, P=0.034）, 1 month （Z=-2.009, P=0.045） and 3 months （Z=-2.120, P=0.034） after LASIK. SIT was significantly higher in the control eyes at 1 week after LASIK （Z=-2.005, P=0.045）. Conclusion An absorbable punctal plug is an effective method for treating dry eye patients after LASIK.