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目的 :准分子激光原位角膜磨镶术 (LASIK)后患者多有干眼症状 ,导致这些变化的机制并不很清楚。本研究的目的是观察和探讨LASIK对泪膜功能的影响。方法 :采用Moria2自动板层刀 ,鹰视准分子激光仪 ,对 6 5例 (130只眼 )近视患者行LASIK ,男 34例 (6 8只眼 ) ,女 31例 (6 2只眼 ) ,年龄 18～ 4 2岁 ,观察术前、术后 1天、1周、1个月的干眼症状 ,泪液分泌试验(Schirmer试验Ⅰ )及泪膜破裂时间 (BUT)变化结果 ,对数据进行统计学分析。结果 :术前 16 9%患者 (2 2 /96 )有干眼症状 ,术后 1天、1周和 1个月分别是 94 6 % (12 3/12 0 ) ;80 % (10 4 /130 ) ;5 8 4 % (76 /12 3)的患者有干眼症状明显加重 ,1个月接近术前水平 ;术后 1天泪液分泌量增多 ,与术前比较差异有显著意义。术后 1周泪液分泌量减少 ,但与术前比较差异有显著意义。术后 1个月泪液分泌量较术前无明显减少 ,差异无显著意义 (P >0 0 5 ) ,术后 1天、1周、1个月和BUT均较术前缩短 (P <0 0 5 )。结论 :LASIK对泪膜的稳定性有一定程度的不良影响 ,术后常导致干眼症状的发生 ,其发生机制与多种因素有关。术前行泪液分泌 (Schirmer试验Ⅰ )、泪膜破裂试验BUT等检查排除干眼症状 ,术后使用人工泪液对LASIK患者是有益的。
OBJECTIVE: There are many dry eye symptoms in patients after laser in situ keratomileusis (LASIK). The mechanisms leading to these changes are not clear. The purpose of this study is to observe and explore the impact of LASIK on tear film function. Methods: LASIK was performed in 65 cases (130 eyes) of myopia with Moria2 automatic lamellar knife and Eagle’s eye laser scanner. There were 34 males (68 eyes) and 31 females (62 eyes) (Aged 18-4 2 years). The dry eye symptoms, tear secretion test (Schirmer test Ⅰ) and tear film breakup time (BUT) were observed before operation, 1 day, 1 week, 1 month after operation. Analysis. Results: There were dry eye symptoms in 16 9% of the patients before operation (94.6% (12 3/12 0), 80% (10 4/130) ); 58.4% (76/123) of patients had dry eye symptoms were significantly increased, 1 month close to the preoperative level; 1 day postoperative tear secretion increased, compared with the preoperative difference was significant. One week after operation, the secretion of lacrimal fluid decreased, but compared with the preoperative difference was significant. There was no significant difference in the amount of lacrimal fluid one month after operation between the two groups (P> 0.05), and the postoperative 1 day, 1 week, 1 month and BUT were shorter than those before operation (P <0 0 5). Conclusion: LASIK has a certain degree of adverse effect on the stability of tear film. Postoperatively, dry eye symptoms often occur. The mechanism of LASIK is related to many factors. Preoperative tear secretion (Schirmer test Ⅰ), tear film rupture test BUT and other tests to rule out symptoms of dry eye, postoperative use of artificial tears in patients with LASIK is beneficial.