心理干预对飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)围手术期干眼的影响  

Effect of psychological intervention on dry eyes during perioperative period of FS-LASIK

作　　者：朱天宇 邹泉 李俊池 耿子旸 朱宇豪 蒋乐 Zhu Tianyu;Zou Quan;Li Junchi;Geng Ziyang;Zhu Yuhao;Jiang Le(Department of Ophthalmic Function,the Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou First People’s Hospital,Institute of Eye Disease Prevention and Treatment of Xuzhou,Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属徐州市立医院眼功能科、徐州市第一人民医院、徐州市眼病防治研究所,徐州221002

出　　处：《中华眼外伤职业眼病杂志》2023年第6期470-474,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：江苏省研究生科研与实践创新计划项目 (SJCX22-1263)。

摘　　要：目的探讨心理干预对准分子激光原位角膜磨镶术(FS-LASIK)围手术期术者干眼情况的影响。方法前瞻性病例对照研究。收集2022年1月至2022年8月于徐州市第一人民医院行FS-LASIK术矫正近视39例(74眼)的临床资料,随机分为观察组22例(42眼)和对照组17例(32眼),观察组于FS-LASIK围手术期进行系统化的心理干预措施,对照组于FS-LASIK围手术期不采取心理干预。分析两组受术者首次泪膜破裂时间(BUTf)、平均泪膜破裂时间(BUTav)及眼表疾病指数量表(OSDI)评分情况。结果术后3个月,观察组和对照组的屈光状态、BUTf、BUTav差异均无统计学意义(均P>0.05),但观察组OSDI评分为(8.67±2.42)分,对照组OSDI评分为(18.03±9.16)分,差异有统计学意义(P<0.001);术后对照组BUTf(t=4.44,P=0.001)和BUTav(t=4.50,P=0.001)显著降低,OSDI评分显著增高(t=-3.31,P=0.02)。通过Pearson相关性分析发现,观察组OSDI评分与年龄呈显著正相关(r=0.33,P=0.042);对照组OSDI评分与BUTf呈显著负相关(r=-0.65,P<0.001);对照组OSDI评分与BUTav也呈显著负相关(r=-0.49,P=0.004)。结论系统化心理干预对FS-LASIK术后OSDI评分具有显著影响,术后规范用药增强泪膜稳定性,降低围手术期干眼对视觉质量的影响。Objective To investigate the effect of psychological intervention on perioperative dry eye in patients undergoing femtosecond laser-assisted in situ keratomileusis(FS-LASIK).Methods This was a prospective case control study.At total of 74 eyes of 39 cases who underwent FS-LASIK for myopia correction in Xuzhou First People’s Hospital from Jan.2022 to Aug.2022 were collected and randomly divided into the observation group with 42 eyes of 22 cases and the control group with 32 eyes of 17 cases.Systematic psychological intervention was carried out in the FS-LASIK perioperative period of the observation group,and no psychological intervention was taken in the FS-LASIK perioperative period in the control group.The tear break-up first time(BUTf),tear break-up average time(BUTav)and ocular surface disease index(OSDI)scores were observed in the two groups.Results There were no statistically significant differences in refractive status,BUTf and BUTav between the two groups after surgery(all P>0.05),but the OSDI score of the observation group was(8.67±2.42)points.OSDI score of control group was(18.03±9.16)points,and the difference was statistically significant(P<0.001).BUTf(t=4.44,P=0.001)and BUTav(t=4.50,P=0.001)were significantly decreased and the OSDI score(t=-3.31,P=0.002)was significantly increased.Pearson correlation analysis showed that OSDI score in the observation group was significantly positively correlated with age(r=0.33,P=0.042),In control group,OSDI score was negatively correlated with BUTf(r=-0.65,P<0.001).There was also a significant negative correlation between OSDI score and BUTav in control group(r=-0.49,P=0.004).Conclusion Systematic psychological intervention have a significant impact on OSDI score after FS-LASIK,standard medication after operation can enhance the stability of tear film and reduce the influence of perioperative dry eye on visual quality.

关 键 词：近视 飞秒激光制瓣的准分子激光原位角膜磨镶术 干预 心理 干眼 

分 类 号：R779.6[医药卫生—眼科]