薄瓣LASIK术后泪液功能的临床观察

发布时间：2019-03-04 17:11

【摘要】：目的探讨飞秒激光制瓣(femtosecond laser in situ keratomileusis,fs-LASIK)和准分子激光前弹力层下角膜磨镶术(one use-plus sub-Bowman’s keratomileusis,OUP-SBK)两种薄瓣LASIK术后患者在泪液功能和角膜染色方面的变化。方法 15例(30眼)行飞秒激光制瓣的LASIK(飞秒激光制瓣组),15例(30眼)行OUP-SBK(OUP-SBK组)。术前及术后1周、1个月、3个月行泪膜破裂时间(tear break-up time,BUT)、基础泪液分泌试验(SchirmerⅠtest,SIt)以及角膜荧光素染色(fluorescent,FL)检查。多个时间点的比较采用重复测量设计的方差分析或Kruskal-Wallis秩和检验,两组间的比较采用两独立样本t检验或秩和检验。结果 fs-LASIK组、OUP-SBK组角膜瓣厚度分别为(105.5±2.7)μm、(103.2±12.5)μm,两组间差异无统计学意义(P0.05)。术后各时间点飞秒激光制瓣组(F=95.48,P0.01)和OUP-SBK组(F=78.25,P0.01)的BUT值均明显低于术前。飞秒激光制瓣组(F=26.96,P0.01)和OUP-SBK组(F=32.11,P0.01)术后各时间点的SIt值明显低于术前。术后1周时飞秒激光制瓣组(Z=4.72,P0.008)和OUP-SBK组(Z=4.18,P0.008)的FL均较术前增多、术后1个月、3个月时与术前差异均无统计意义(均为P0.008)。两组间各时间点的各项观察指标差异均无统计学意义(均无P0.05)。结论飞秒激光制瓣LASIK和OUP-SBK两种术后的BUT、SIt值和FL变化一致,术后的泪膜稳定性和分泌功能随着时间的推移逐渐恢复,且两者的角膜组织损伤均在早期得到修复。
[Abstract]:Objective to investigate the effects of femtosecond laser flap making (femtosecond laser in situ keratomileusis,fs-LASIK) and excimer laser anterior subelastic keratomileusis (one use-plus sub-Bowman's keratomileusis,). OUP-SBK) changes in lacrimal function and corneal staining after two kinds of thin flap LASIK. Methods Fifteen patients (30 eyes) were treated with LASIK (femtosecond laser flap group) and 15 patients (30 eyes) were treated with OUP-SBK (OUP-SBK group). The lacrimal film rupture time (tear break-up time,BUT), Schirmer I test, SIt) and corneal fluorescein staining (fluorescent,FL) were performed before and 1 week, 1 month and 3 months after operation. Multiple time points were compared by ANOVA or Kruskal-Wallis rank sum test designed by repeated measurements, and two independent sample t-test or rank sum test were used for comparison between the two groups. Results the thickness of corneal flap in fs-LASIK group and OUP-SBK group was (105.5 卤2.7) 渭 m and (103.2 卤12.5) 渭 m, respectively. There was no significant difference between the two groups (P0.05). The values of but in femtosecond laser valvuloplasty group (F = 95.48, P0.01) and OUP-SBK group (F = 78.25, P0.01) were significantly lower than those before operation. The values of SIt in femtosecond laser valvuloplasty group (F = 26.96, P0.01) and OUP-SBK group (F = 32.11, P0.01) were significantly lower than those before operation. The FL of femtosecond laser valvuloplasty group (Z = 4.72, P < 0.008) and OUP-SBK group (Z = 4.18, P < 0.008) were increased at 1 week after operation, but there was no significant difference between the two groups at 1 month and 3 months after operation (all P 0.008). There was no significant difference in each observation index between the two groups at each time point (P 0.05). Conclusion the changes of BUT,-sit and FL after femtosecond laser valvuloplasty LASIK and OUP-SBK are consistent. The stability and secretion function of lacrimal film gradually recover with the passage of time, and the corneal tissue damage is repaired in the early stage.
【作者单位】：中山大学中山眼科中心海南眼科医院(海南省眼科医院) 海南省眼科研究所;
【基金】：国家眼科学重点实验室自主研究基金项目(编号3030902113006)~~
【分类号】：R779.63

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