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目的 探讨准分子激光原位角膜磨镶术 (laserinsitukeratomileusis ,LASIK)术后泪膜的早期改变。方法 对 74例 (14 8只眼 )近视患者行LASIK ,观察术前 ,术后 1d、1周、1个月、3个月的干眼症状 ,包括干涩感、异物感、烧灼感 ,以及荧光素试验、孟加拉玫瑰红染色、泪膜破裂时间 (breakuptimeoftearfilm ,BUT)和泪液分泌量结果 ,并对数据进行统计学分析。结果 术后 1周干燥感较术前加重(P <0 0 12 7) ,其他时间与术前比较差异均无显著意义 (P >0 0 12 7) ;术后 1d和 1周烧灼感较术前加重 (P <0 0 12 7) ,术后 1个月、3个月与术前比较差异无显著意义 (P >0 0 12 7) ;术后 1d、1周和1个月异物感较术前明显加重 (P <0 0 12 7) ,3个月接近术前水平 (P >0 0 12 7)。术后 1d和 1周角膜荧光素着色点较术前明显增多 (P <0 0 12 7) ,术后 1个月和 3个月与术前比较差异无显著意义(P >0 0 12 7) ;术后 1d和 1周孟加拉玫瑰红着色点较术前明显增多 ,差异有显著意义 (P <0 0 12 7) ,术后 1个月和 3个月接近术前水平 (P >0 0 12 7) ;术后 1周和 3个月泪液分泌量较术前明显减少 ,差异有显著意义 (P <0 0 5 ) ,术后 1个月接近术前水平 (P >0 0 5 ) ;术后 1d、1周、1个月和 3个月BUT均较术前缩短 (P <0 0 5 )。
Objective To investigate the early changes of tear film after laser in situ keratomileusis (LASIK). Methods LASIK was performed in 74 patients (14 8 eyes) with myopia. The symptoms of dry eye, including dryness, foreign body sensation, burning sensation and fluorescence before operation, 1 day, 1 week, 1 month, 3 months after operation were observed. The results of the test, Bengal rose bengal staining, breakup time of stearfilm (BUT) and lacrimal fluid secretion, and the data were statistically analyzed. Results One week after operation, the sensation of dryness was worse than that before operation (P <0 0 12 7). There was no significant difference at other times compared with that before operation (P> 0 0 12 7) (P <0 0 12 7). There was no significant difference at 1 month, 3 months after operation between preoperative and postoperative (P> 0 0 12 7). The foreign body sensation at 1 day, 1 week and 1 month after operation Preoperative significantly increased (P <0 0 12 7), 3 months close to the preoperative level (P> 0 0 12 7). The corneal fluorescein staining points at 1 day and 1 week after operation were significantly higher than those before operation (P <0 0 12 7). There was no significant difference between preoperative and postoperative 1 month and 3 months postoperatively (P0 0 12 7) (P <0 0 12 7). The 1-month and 3-month post-operation rose rose coloration points were significantly higher than preoperative levels (P 0 01 12) 7). The amount of lacrimal fluid secretion at 1 week and 3 months after operation was significantly lower than that before operation (P <0.05), and was close to preoperative level at 1 month (P> 0.05) The BUT at 1 day, 1 week, 1 month and 3 months after operation were shorter than those before operation (P <0.05).