Keratograph眼表综合分析仪观察不同年龄患者飞秒激光制瓣LASIK术后泪膜变化

发布时间：2018-05-27 20:37

本文选题：飞秒激光 + 准分子激光原位角膜磨镶术　；参考：《国际眼科杂志》2016年03期

【摘要】：目的:观察Keratograph眼表综合分析仪检查不同年龄组患者飞秒激光制瓣准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后泪膜的变化。方法:选择性收集2014-07/2015-06在中山市人民医院行飞秒激光制瓣LASIK的患者75例150眼,要求30岁以下、30~40岁、40岁以上患者各选取25例50眼。检查术前,并随访术后1wk,1、2、3mo时患者的Keratograph眼表综合分析仪检查的泪膜破裂时间(tear break-up time,BUT)、泪河高度(tear meniscus height,TMH),并应用Mc Monnies干眼病史问卷调查表(Mc Monnies Questionnaire,MQ)评估干眼症状得分。结果:三组患者术前干眼症状评分差异无统计学意义(P0.05),术后各时间点差异均有统计学意义(P0.05),均为30岁组最低,40岁以上组最高。术后1wk,三组干眼症状评分均较术前明显上升,随后均逐渐下降。其中,30岁以下、30~40岁组在术后2mo评分下降至术前水平,40岁以上组在术后3mo下降到术前水平。三组患者术前和术后各时点BUT和TMH差异均有统计学意义(P0.05),两指标均为30岁组最高,40岁以上组最低。术后1wk,三组患者两指标均较术前明显下降,随后均逐渐上升。其中,30岁以下、30~40岁组在术后3mo BUT回升至术前水平,而40岁以上组未回升到术前水平;30岁以下的TMH在术后2mo即回升到与基线没有统计学差异,30~40岁组、40岁以上组的TMH在术后3mo回升到与基线没有统计学差异。结论:飞秒激光制瓣LASIK术可影响干眼症状和泪膜的稳定性,影响程度随术后时间逐渐减弱,年龄越小的患者更快恢复至术前水平。
[Abstract]:Objective: to observe the changes of tear film after laser in situ keratomileusissis (LASIKA) in patients with femtosecond laser flap making excimer laser in situ keratomileusis (LASK) by Keratograph ocular surface comprehensive analyzer. Methods: 75 patients (150 eyes) who received femtosecond laser flap LASIK in Zhongshan people's Hospital in 2014-07 / 2015-06 were selected. 25 cases (50 eyes) of patients under 30 years old or over 40 years old were selected. The time of lacrimal film rupture was detected by Keratograph ocular surface comprehensive analyzer before operation and 1 week after operation. The tear film rupture time was tear break-up time, and the tear film height was higher than that of meniscus TMH. Mc Monnies dry eye history questionnaire and MC Monnies questionnaire were used to evaluate dry eye symptoms. Results: there was no significant difference in preoperative dry eye score among the three groups (P 0.05), but there was a significant difference at every time point after operation (P 0.05), which was the lowest in 30 years old group and the highest in more than 40 years old group. At 1 week after operation, the dry-eye symptom scores in all three groups increased significantly compared with those before operation, and then decreased gradually. The 2mo score decreased to the preoperative level in the group under 30 years old and the 3mo level decreased to the preoperative level in the group over 40 years old. There were significant differences in BUT and TMH between the three groups before and after operation (P 0.05). The two indexes were the highest in 30 years old group and the lowest in more than 40 years old group. At 1 wk after operation, the two indexes in the three groups were significantly lower than those before operation, and then increased gradually. In the group under 30 years old and 40 years old, the 3mo BUT level increased to the preoperative level after operation. However, the TMH of the group over 40 years old did not return to the preoperative level. The 2mo of the patients under 30 years of age increased to the baseline after operation. There was no significant difference between the TMH of the group of 30 and 40 years old and that of the group of over 40 years old. There was no statistical difference between the 3mo and the baseline after the operation. Conclusion: Femtosecond laser flap making LASIK can affect the stability of dry eye and tear film.
【作者单位】：中国广东省中山市人民医院眼科;
【基金】：国家自然科学基金(No.81300731)~~
【分类号】：R779.63

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