准分子激光角膜原位磨镶术术后干眼症的研究

目的观察准分子激光角膜原位磨镶术（LASIK）前、后角膜知觉、泪膜功能、结膜杯状细胞情况,初步探讨LASIK术后干眼症情况。方法 90例180眼行LASIK近视患者分别于术前,术后1周,术后1、3、6个月行基础泪液分泌试验（Sit）、泪膜破裂时间（BUT）测定、角膜知觉检查、角结膜荧光素钠染色检查及术前,术后1、3、6个月行结膜印迹细胞学检查。结果 Sit值术后各期均较术前减少,但差异无统计学意义（P＞0.05）;术后1周,术后1、3个月BUT值较术前明显缩短,差异有统计学意义（P〈0.05）,角膜知觉较术前明显下降,差异有统计学意义（P〈0.01）,均于术后6个月恢复,术后各期角结膜荧光素钠染色与术前比较差异均无统计学意义（P＞0.05）,术后1、3个月结膜上皮鳞状化生程度较术前明显加重,差异有统计学意义（P〈0.01）,6个月后恢复。结论 LASIK术后会出现不同程度的泪膜稳定性下降、角膜知觉减退、眼表组织损害,但随时间延长会逐渐恢复。

Investigation on xerophthalmia after laser assisted in-situ keratomi leusis

Objective To investigate symptoms of xerophthalmia after laser assisted in-situ keratomi leusis（LASIK）.Methods LASIK was performed in 180eyes of 90patients.SchirmerⅠtest（Sit）,detection of breakup time of tear film（BUT）,corneal sensitivity,corneal and conjunctiva sodium fluorescein were performed before and 1week,1,3and 6months after LASIK therapy,and conjunctival impression cytology detection was performed 1,3and6months after therapy.Results After LASIK therapy,Sit value decreased,but the difference was not significant（P〉0.05）.BUT and corneal sensitivity decreased at 1week,1and 3months after therapy（P〈0.05）,but recovered at 6months after therapy.Sodium fluorescein were without statistical difference at all time（P〉0.05）.Impression cytology had significant damage at 1and 3months after therapy（P〈0.05）,but recovered at 6months.ConclusionLASIK could break down tear-film stability,decrease corneal sensitivity,damage oculo-surface tissue,but all of these symptoms could be recovered gradually.