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目的:观察最优化屈光性角膜切削术(optimized refractive keratectomy,ORK)后泪液分泌、泪膜稳定性的改变,分析其与干眼的关系。方法:随机选择80名近视眼患者实施双眼ORK手术,分别用荧光素法和schirmerⅠ试验(基础分泌试验)测定患者术前、术后1周、1个月、3个月、6个月的泪膜破裂时间(break up time,BUT)和泪液分泌值。结果:①schirmer值(单位:mm):术前为18.22±5.29,术后1周、1个月、3个月、6个月分别为8.06±2.81,10.30±3.22,13.24±3.72,16.80±4.48;术后1周、1个月、3个月和6个月Schirmer值分别与术前比较,差异有显著性意义(P<0.01)。②BUT值(单位:s):术前为19.68±5.77,术后1周、1个月、3个月、6个月分别为9.69±2.91,12.11±3.32,14.99±4.15,18.83±5.05;术后1周、1个月、3个月和6个月分别与术前的BUT值比较,差异均有显著性意义(P<0.01)。结论:ORK术后6个月内,泪膜稳定性下降及泪液分泌减少,但有逐渐恢复的趋势。
Objective: To observe the changes of lacrimal fluid secretion and tear film stability after optimized refractive keratectomy (ORK), and to analyze its relationship with dry eye. Methods: Eighty patients with myopia were randomly selected for ORK surgery. Fluorescein and schirmer Ⅰ test (basal secretion test) were used to determine the patients ’preoperative and postoperative 1 week, 1 month, 3 months and 6 months’ Break up time (BUT) and tear secretion value. Results: ① Schirmer value (unit: mm): preoperative 18.22 ± 5.29, 1 week after surgery, 1 month, 3 months and 6 months were 8.06 ± 2.81,10.30 ± 3.22,13.24 ± 3.72,16.80 ± 4.48 ; Schirmer values at 1 week, 1 month, 3 months and 6 months after operation were significantly different from those before operation (P <0.01). ② BUT value (unit: s): 19.68 ± 5.77 before operation, 9.69 ± 2.91, 12.11 ± 3.32, 14.99 ± 4.15 and 18.83 ± 5.05 respectively at 1 week, 1 month, 3 months and 6 months after operation After 1 week, 1 month, 3 months and 6 months, respectively, compared with preoperative BUT values, the differences were significant (P <0.01). Conclusion: Within 6 months after ORK surgery, tear film stability and tear secretion decreased, but gradually recovered.