LAISK术后蠕形螨感染对眼表损伤的临床研究

目的 探讨准分子激光原位角膜磨镶术（laser-assisted in situ keratomileusis，LASIK）术后蠕形螨感染患者的眼表特征。设计 回顾性病例系列。研究对象2017年9月至2018年5月在北京同仁医院就诊的56例螨虫性睑缘炎患者，分为LASIK术后组（9例）和对照组（47例）。方法 采用Keratograph5M眼表综合分析仪和泪液分泌试纸对两组患者进行眼表检查，包括角膜荧光染色（cornea fluorescein staining，FL），泪膜破裂时间（tear film break-up time, TBUT），眼红分析（conjunctival hyperemia index, CHI），睑板腺照相和泪液分泌试验（Schirmer I test, SIt）。主要指标  FL评分，非侵入式TBUT，结膜眼红指数，睑板腺评分和基础泪液分泌量。结果  LASIK术后组的FL评分（1.3±1.0）明显高于对照组（0.38±0.15）（P＜0.01）；而LASIK术后组 TBUT（10.55±5.8）s，CHI（1.7±0.5），SIt（16.4±3.8）mm，睑板腺评分（1.42±1.0）与对照组TBUT（9.93±5.3）s，CHI（1.74±0.67），SIt（14.0±11.2）mm，睑板腺评分（1.45±1.03）相比差异无统计学意义（P均＞0.05）。结论 LASIK术后的患者发生螨虫性睑缘炎更容易继发角膜上皮点状病变，加重眼表损伤。

Clinical study of ocular surface damage caused by demodex infection after LAISK

Objective To investigate the clinical features of ocular surface of patients with demodex infection after laser-assisted in situ keratomileusis (LASIK). Design Retrospective case series. Participants 56 patients with demodex blepharitis who were admitted to Beijing Tongren Hospital from September 2017 to May 2018. They were divided into LASIK group (n=9) and control group (n=47). Methods The ocular surface examination was performed on two groups of patients using Keratograph5M ocular surface comprehensive analyzer and tear secretion test, including cornea fluorescence staining (FL), tear film break-up time (TBUT), and red eye analysis (conjunctival hyperemia index, CHI), meibomian gland photography and tear secretion test (Schirmer I test, SIt). Main Outcome Measure Corneal FL score, non-invasive TBUT, CHI, meibomian gland score and basic tear secretion. Results The FL value of the LASIK group (1.3±1.0) was significantly higher than that of the control group (0.38±0.15) (P<0.01). TBUT (10.55±5.8) s, CHI (1.7±0.5), SIt (16.4±3.8)mm, and meibomian gland score (1.42±1.0) in LASIK group were no significant difference with the TBUT (9.93±5.3) s, CHI (1.74±0.67), SIt (14.0±11.2)mm, and meibomian gland score (1.45±1.03) in controls (all P>0.05). Conclusion Demodex blepharitis in patients after LASIK is more likely to secondary to corneal epithelial punctate lesions and aggravate ocular surface damage.