飞秒激光制瓣LASIK术后泪膜变化及相关性分析  

Analysis of the tear film changes after laser in situ keratomileusis （LASIK） with corneal flap created by femtosecond laser

作　　者：张媛[1] 贾冰冰[1] 张岩[1] 高冬梅[1] 庞玉珍[1] 谷树严[1] 

机构地区：[1]长春爱尔眼科医院,130002

出　　处：《中国实用眼科杂志》2014年第11期1313-1316,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察飞秒激光制瓣准分子激光原位角膜磨镶术后泪膜的变化,BUT、泪液分泌试验和泪河高度的相关性.方法 临床病例系列研究.收集2013年8～9月长春爱尔眼科医院行飞秒激光制瓣LASIK术并随访3个月的患者120例（240只眼）,观察术前、术后1周、1、2和3个月患者的荧光素检查的泪膜破裂时间（BUT）、Oculus角膜地形图仪检查的BUT、泪液分泌试验（S Ⅰ t）、Oculus角膜地形图仪检查的泪河高度（TMH）的变化,同时观察荧光素BUT和Oculus BUT、泪液分泌试验和Oculus泪河高度的相关性.结果 Oculus BUT：术后1周与术前相比有差异有统计学意义（P=0.00＜0.05）,术后1、2、3个月与术前相比差异无统计学意义（P =0.556,0.663,0.087＞0.05）.荧光素BUT：术前荧光素BUT与术后1周、l、2、3个月相比均差异有统计学意义（P =0.033,0.025,0.004,0.000＜ 0.05）.Schirmer Ⅰ试验：术后1周、1个月与术前差异有统计学意义（P =0.000,0.002＜0.05）,术后2、3个月与术前差异无统计学意义（P=0.776,0.753＞0.05）.泪河高度：术后1周、1个月与术前相比差异有统计学意义（P =0.00＜0.05）,术后2、3个月与术前相比差异无统计学意义（P =0.096,0.229＞0.05）.Oculus BUT和荧光素BUT相关分析：相关关系为正相关.泪河高度和Schirmer Ⅰ相关分析：无相关关系.结论 飞秒激光制瓣准分子激光原位角膜磨镶术术后早期影响泪膜的稳定性;Oculus角膜地形图仪非侵入性BUT检查具有可靠性,重复性较好,可以作为临床干眼诊断的一个参考标准.Objective To observe the tear film changes on the patients after laser in situ keratomileusis （LASIK） with corneal flap created by femtosecond laser; the correlation among the BUT,Schirmer Ⅰ test and tear meniscus height.Methods The 120 myopic patients （240 eyes） who underwent femtosecond laser surgery from August to September 2013,these patients were followed up for three months.Tear break-up time （BUT） with fluorescein,tear break-up time （BUT） with Oculus corneal topography,Schirmer Ⅰ test,tear meniscus height with Oculus corneal topography and corneal fluorescein staining were recorded preoperatively and postoperatively in the first week,the first month,the second month and the third month.And observed the correlation between tear break-up time （BUT） with fluorescein and tear break-up time （BUT） with Oculus corneal topography,Schirmer Ⅰ test and tear meniscus height with Oculus corneal topography.Results Oculus BUT：There existed obvious difference （P =0.00 ＜0.05） in the first week compared with the preoperative level.While no such obvious difference （P =0.556,0.663,0.087＞0.05） existed in the first month,the second month and the third month compared with the preoperative level.Fluorescein BUT：There existed obvious difference （P =0.033,0.025,0.004＜0.05） in the first week,the first month,the second month and the third month compared with the preoperative level.Schirmer Ⅰ test：There existed obvious difference （P =0.000,0.002＜0.05） in the first week and the first month compared with the preoperative level.No such obvious difference （P =0.776,0.753＞0.05） existed in the second month and the third month compared with the preoperative level.Tear meniscus height （TMH）：There cxisted obvious difference （P =0.00＜0.05） in the first week and the first month compared with the preoperative level.No such obvious difference （P =0.096,0.229＞0.05） existed in the second month and the third month compared with the preoperative level.The correlation

关 键 词：飞秒激光 准分子激光原位角膜磨镶术 干眼 泪膜 

分 类 号：R779.6[医药卫生—眼科]