LASIK术后泪膜及角膜地形图早期改变的临床研究

发布时间：2018-12-12 04:52

【摘要】：目的:探讨LASIK术后泪膜及角膜地形图的早期改变,研究泪膜变化及其与角膜地形图改变的关系及LASIK术后干眼的原因,指导LASIK术后治疗。方法:选择2010年4月至2010年10月期间在我院近视治疗中心行LASIK手术的患者62例(120只眼,其中有4例为单眼手术)分别于术前、术后1周、1月、3月、6月询问患者干眼的主观症状并常规检查裸眼视力,裂隙灯检查角膜瓣情况,同时行角膜地形图(Humphrey ATLAS Corneal Topography Systems)检查角膜不规则指数(Corneal Irregularity Measurement,CIM)、角膜形态因素(Shape Factor, SF),角膜荧光素染色、泪膜破裂时间(Tear Break Up Time, BUT)及Schirmer I试验(Schirmer I test, SIt)。结果:LASIK术后1周、1月、3月干眼症状较术前加重(P0.01),术后6月基本恢复(P=0.3930.05)。角膜荧光素染色术后术后1周、1月、3月较术前加重(P0.05),术后6月基本恢复P=0.3830.05。SIt值于术后1周、1月、3月较术前均减少(P0.01),但术后6月时基本恢复(P=0.7040.05)。BUT术后1周、1月、3月、6月与术前相比缩短(P0.01),6月尚未恢复。CIM值术后1周、1月、3月、6月较术前增加(P0.01)。SF值术后1周、1月、3月、6月较术前增加(P0.01)。LASIK术后BUT及CIM存在幂函数负相关关系,相关系数为r=0.393。BUT与SF有直线正相关关系,相关系数为r=0.436。SIt与CIM存在三次模型相关关系,相关系数为r=0.320。结论:LASIK术后患者眼干症状加重,术后1周、1月、3月泪液分泌量减少,明显低于术前水平,术后6月时基本恢复。泪膜稳定性也受到破坏,6月时仍未恢复。LASIK手术会导致角膜不规则性增加及角膜形态改变,术后1周增加明显,6月时仍未完全恢复,泪膜稳定性下降与LASIK术后角膜不规则性增加及角膜形态改变相关。
[Abstract]:Objective: to investigate the early changes of tear film and corneal topography after LASIK, to study the relationship between the changes of tear film and corneal topography and the causes of dry eye after LASIK, and to guide the treatment after LASIK. Methods: from April 2010 to October 2010, 62 patients (120 eyes, 4 of whom underwent monocular surgery) underwent LASIK operation in our myopia treatment center, one week, one month and three months after operation, respectively. In June, patients were asked about the subjective symptoms of the dry eye and their visual acuity was examined routinely. Slit lamp was used to examine the corneal flap. Meanwhile, corneal topography (Humphrey ATLAS Corneal Topography Systems) was performed to examine the corneal irregular index (Corneal Irregularity Measurement,CIM), corneal morphological factor (Shape Factor,). SF), cornea fluorescein staining, tear film rupture time (Tear Break Up Time, BUT) and Schirmer I test (Schirmer I test, SIt). Results: the symptoms of dry eye in 1 week, 1 month and 3 months after LASIK were more serious than those before operation (P0.01), and basically recovered at 6 months after LASIK (P0. 3930.05). Corneal fluorescein staining after 1 week, 1 month, 3 months compared with the preoperative aggravated (P0.05), 6 months after the basic recovery of P=0.3830.05.SIt in the postoperative 1 week, 1 month, 3 months compared with the preoperative decreased (P0.01), But at 6 months after operation, it recovered basically (P < 0. 704 0. 05). BUT, 1 week, 1 month, 3 months, 6 months compared with pre operation (P0. 01). CIM value was 1 week, 1 month, 3 months after operation, P < 0. 01, P 0. 01, P 0. 01). There was a negative correlation between BUT and CIM after P0.01). LASIK. The correlation coefficient was that there was a linear positive correlation between r=0.393.BUT and SF. The correlation coefficient between r=0.436.SIt and CIM is cubic, and the correlation coefficient is 0.320. Conclusion: the dry eye symptoms of LASIK patients were aggravated and the amount of tear secretion decreased at 1 week, 1 month and 3 months after operation, which was significantly lower than that before operation, and recovered basically at 6 months after operation. The stability of lacrimal film was also damaged, and it was still not recovered at 6 months. LASIK operation resulted in the increase of corneal irregularity and corneal morphology, the increase was obvious at 1 week after operation, and the recovery was not complete at 6 months. The decrease of tear film stability was related to the increase of corneal irregularity and corneal morphology after LASIK.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R779.63

【参考文献】