准分子激光角膜原位磨镶术后泪膜变化及与角膜知觉关系的研究  

The early-stage changes in tear and tear film as well as corneal sensitivity after LASIK for myopia

作　　者：王礴[1] 刘汉强[2] 李敏[1] 张丽红[1] 刘宏文[1] 

机构地区：[1]鞍山市中心医院眼科 [2]中国医科大学附属第一医院眼科,110001

出　　处：《中国实用眼科杂志》2003年第7期506-510,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :探讨准分子激光角膜原位磨镶术 (laserinsitukeratomileusis ,LASIK )后泪液 ,泪膜变化及其与角膜知觉的关系 ,研究LASIK术后发生眼干现象的原因。方法 :对 5 0名近视眼患者实施双眼LASIK手术 ,分别测定其术前 ,术后一周 ,二周和四周的泪液分泌值 ,泪膜稳定性和角膜知觉值 ,其中泪液分泌值用Schirmerl实验测定 ,泪膜稳定性是通过用英国产KEELER泪膜镜测定非侵入性泪膜破裂时间(NIBUT)来评价 ,角膜知觉用美国产CochetBonnet角膜知觉计来测定。结果 :1 NIBUT值 (单位 :秒 ) :术前为 2 6 2 0± 15 12 ,术后一周为 18 5 6± 15 2 4,术后二周为 18 90± 11 64 ,术后四周为2 4 10± 14 2 4,术后各组分别与术前的NIBUT值进行配对t检验 ,差异均有显著性意义 (P <0 0 5 )。 2 角膜知觉 (单位 :mm) :术前为 5 5 60± 8 18,术后一周为 2 4 78± 19 82 ,术后二周为 3 4 0 2± 19 2 8,术后四周为 5 3 3 0± 10 3 8,术后各组分别与术前的角膜知觉值进行配对t检验 ,术后一周、二周组与术前的差异均有显著性意义 (P <0 0 5 ) ,术后四周与术前的差异无显著性意义 (P >0 0 5 )。 3 Schirmerl值 (单位 :mm ) :术前为 2 0 92± 10 80 ,术后一周为 17 83± 10 64 ,术后二周为 2 0 0 6±11 42 ,术后四周?To investigate the early-stage changes in tear secretion and tear film stability as well as the corneal sensitivity after LASIK for myopia and the relationship between postoperative tear film and corneal sensitivity. Methods:A hundred eyes underwent LASIK were randomly checked with Schirmer tear test,no-invasive tear break up time (NIBUT) and corneal sensitivity before and 1 week,2 weeks,4 weeks after the operation. Results:The mean corneal sensitivity values were 55 60(8 18mm preoperatively;24 78(19 82mm,34 02(19 28mm at 1 week,2 weeks postoperatively (P<0 05),and 53 30(10 38mm at 4 weeks postoperatively (P>0 05).The mean NIBUT values were 26 20(15 12 seconds preoperatively;18 56(15 24 seconds,18 90(11 64 seconds and 24 10(14 24 seconds at 1 week,2 weeks,4 weeks postoperatively (P<0 05).The mean values of Schirmer tear test were 20 92(10 80mm preoperatively;17 83(10 64mm,20 06(11 42mm and 20 44(11 68mm at 1 week,2 weeks and 4 weeks postoperatively (P>0 05).The NIBUT of post-operation positively correlated with corneal sensitivity (r=0 48,P<0 05). Conclusions:Both the tear film stability and the corneal sensitivity decreased after LASK,but tear secretion appeared unaltered.

关 键 词：准分子激光角膜原位磨镶术 泪膜 角膜知觉 稳定性 

分 类 号：R779.63[医药卫生—眼科]