FS-LASIK与去瓣LASEK术后干眼比较

目的:比较飞秒激光辅助的准分子激光原位角膜磨镶术(FS-LASIK)和去瓣乙醇辅助的准分子激光角膜上皮瓣下磨镶术(LASEK)术后的干眼状况。方法:前瞻性临床研究。收集2016年8月至2017年2月在宁波市眼科医院屈光手术中心行FS-LASIK的近视患者(FS-LASIK组)30例(30眼),行去瓣LASEK的近视患者(LASEK组)30例(30眼)。分别在术前及术后3、6、12个月评估2组患者的眼表疾病指数(OSDI)问卷、泪液分泌试验(SⅠT)、泪膜破裂时间(BUT)及角膜荧光素染色。2组数据采用两因素重复测量方差分析进行检验。结果:2组间各时间点OSDI问卷分数、SⅠT和角膜荧光素染色差异均无统计学意义(P>0.05)。FS-LASIK组术前及术后3、6个月的BUT与LASEK组差异无统计学意义(P>0.05),术后12个月的BUT较LASEK组更长(t=2.81,P=0.01)。与术前相比,FS-LASIK组术后3个月的角膜荧光素染色显著增加(t=3.48,P=0.008),术后6、12个月与术前差异无统计学意义(P>0.05),LASEK组术后各时间点的角膜荧光素染色与术前差异无统计学意义(均P>0.05)。2组术后各时间点的OSDI问卷分数和SⅠT与术前差异无统计学意义(均P>0.05)。FS-LASIK组、LASEK组的BUT在术后3、6个月与术前差异无统计学意义(均P>0.05),在术后12个月均较术前显著延长(t=3.14,P=0.01;t=2.43,P=0.04)。结论:FS-LASIK和去瓣LASEK术后干眼程度都较轻,且2种术式对干眼的影响是相似的。

Comparative Study of Dry Eye after FS-LASIK and Off-Flap LASEK

To compare dry eye characteristics in eyes after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) or off-flap laser epithelial keratomileusis (LASEK). Methods: Thirty eyes of 30 patients with myopia who had FS-LASIK (FS-LASIK group) and 30 eyes of 30 patients with myopia who had off-flap LASEK (LASEK group) at the Refractive Surgery Center of the Ningbo Eye Hospital from August 2016 to February 2017 were prospectively enrolled in this clinical study. The Ocular Surface Disease Index (OSDI) questionnaire, Schirmer Ⅰ test (SⅠT), tear breakup time (BUT), and corneal fluorescein staining were evaluated preoperatively and 3, 6, and 12 months postoperatively. Data from the two groups were analyzed with a two-way repeated measures ANOVA. Results: There were no statistically significant differences between the two groups for the OSDI questionnaire score, SⅠT, and corneal fluorescein staining at all time-points and for the preoperative and 3 and 6 months postoperative BUT(P>0.05). The BUT of the FS-LASIK group was higher than that for the LASEK group after 12 months (t=2.81, P=0.01). Compared with the preoperative evaluation, corneal staining increased in the FS-LASIK group after 3 months (t=3.48, P=0.008), but there were no statistically significant differences between 6 and 12 months postoperative and the preoperative. There were no statistically significant differences between postoperative and preoperative for the corneal fluorescein staining in the LASEK group (P>0.05). There were no statistically significant differences between postoperative and preoperative for the OSDI questionnaire score and Schirmer Ⅰ in both groups (P>0.05), and there were no statistically significant differences between 3 and 6 months postoperative and the preoperative for the BUT in both groups (P>0.05). Compared with the preoperative evaluation, the BUT increased in the FS-LASIK and LASEK groups after 12 months (t=3.14, P=0.01; t=2.43, P=0.04). Conclusions: Dry eye is slight after FS-LASIK and off-flap LASEK surgeries, and both techniques have a similar effect on dry eye.