飞秒激光准分子激光原位角膜磨镶术与前弹力层下激光角膜磨镶术术后干眼的对比

目的：：探讨飞秒激光准分子激光原位角膜磨镶术( laser in situ keratomileusis,LASIK)与前弹力层下激光角膜磨镶术( sub-Browman’s keratomileusis,SBK)术后干眼及泪膜功能的变化。方法：回顾性分析2013-01/09在我院接受近视手术患者220例440眼。其中126例252眼为飞秒LASIK组,94例188眼为SBK组,分别观察两组术前及术后1wk,1、3、6mo的角膜荧光素染色( fluorescence staining,FL)、泪膜破裂时间(tear break-up time,BUT)、泪液分泌试验(SchirmerⅠtest,SⅠt)的变化。结果：飞秒LASIK组和SBK组术后1 wk和1 mo荧光素染色评分,两组间比较差异有统计学意义(P<0.05),术后3mo和6mo两组间比较差异无统计学意义(P>0.05)。术后1wk和1mo BUT,两组间比较差异有统计学意义( P<0.05),术后3mo和6mo两组间比较差异无统计学意义(P>0.05)。术后1 wk、1 mo和3 mo Schirmer Ⅰ试验两组间比较差异有统计学意义(P<0.05),术后6mo两组间比较差异无统计学意义(P>0.05)。结论：飞秒LASIK和SBK术后患者早期均有不同程度的干眼,但飞秒LASIK术后的泪膜功能恢复较SBK快。

Comparative study on dry eye after femtosecond laser in situ keratomileusis and sub-Bowman's keratomileusis

AIM:To evaIuate the changes of postoperative dry eye and tear - fiIm after femtosecond Iaser in situ keratomiIeusis ( femto LASIK ) or sub - Bowman’s keratomiIeusis ( SBK) . METHODS: Two hundred and twenty patients ( 440 eyes) accepted the refractive surgery from January to September 2013 in our hospitaI were anaIyzed retrospectiveIy. Two hundred and fifty-two eyes in 126 patients were performed with femto-LASIK, and 188 eyes in 94 cases were performed with SBK. The changes on corneaI fIuorescence staining ( FL ) , tear fiIm break-up time ( BUT ) , and Schirmer I test ( SIt ) were obtained preoperativeIy, 1, 3 and 6mo postoperativeIy. RESULTS:There were significant difference between femo-LASIK and SBK on FL at 1mo postoperativeIy ( P<0. 05 ), and no significant differences at 3 and 6mo postoperativeIy ( P > 0. 05 ). At 1wk and 1mo postoperativeIy, the differences on BUT between the two groups were statisticaIIy significant (P<0. 05), and no significant differences at 3 and 6mo postoperativeIy ( P>0. 05). At 1wk,1 and 3mo postoperativeIy, the differences on SIt between the two groups were statisticaIIy significant (P<0. 05). However, there was no significant difference at 6mo postoperativeIy on SIt between the two groups (P>0. 05). CONCLUSION:Both patients treated by femto-LASIK or SBK have dry eye after surgeries in earIy stage. However, tear-fiIm function in femto-LASIK group recovers faster than that in SBK group.