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准分子激光上皮下角膜磨镶术后角膜感觉、眼表完整性和泪膜功能的早期变化

Early changes in corneal sensation, ocular surface integrity, and tear-film function after laser-assisted subepithelial keratectomy.

作者信息

Horwath-Winter Jutta, Vidic Bertram, Schwantzer Gerold, Schmut Otto

机构信息

Department of Ophthalmology, University of Graz, Graz, Austria.

出版信息

J Cataract Refract Surg. 2004 Nov;30(11):2316-21. doi: 10.1016/j.jcrs.2004.03.042.

Abstract

PURPOSE

To investigate the changes in corneal sensation, ocular surface integrity, and tear-film function after laser-assisted subepithelial keratectomy (LASEK).

SETTING

Department of Ophthalmology, University of Graz, Graz, Austria.

METHODS

Laser-assisted subepithelial keratectomy was performed in 21 consecutive patients (37 myopic eyes). The patients were observed for subjective complaints of dry eye, corneal sensation, tear-film breakup time (BUT), Schirmer test without local anesthesia, and fluorescein and lissamin-green staining preoperatively and 1 week and 1, 3, and 6 months postoperatively.

RESULTS

The subjective score for dry-eye symptoms was not statistically significantly higher after the procedure. Corneal sensation was reduced up to 1 month after LASEK (P<.05). There were obvious decreases in BUT at 1 week and 1 month (P<.01) and no significant changes in Schirmer test results. In fluorescein staining of the cornea, dots were more concentrated at 1 week (P<.05). In lissamin-green staining, no significant changes were found at any follow-up examination.

CONCLUSIONS

Laser-assisted subepithelial keratectomy induced a short-term reduction in corneal sensation and affected the ocular surface and tear film slightly. Epithelial flap repositioning in LASEK may have a positive influence on tear-film and ocular-surface factors.

摘要

目的

探讨准分子激光上皮下角膜磨镶术(LASEK)后角膜感觉、眼表完整性和泪膜功能的变化。

设置

奥地利格拉茨大学眼科。

方法

对21例连续患者(37只近视眼)实施准分子激光上皮下角膜磨镶术。术前及术后1周、1、3和6个月观察患者干眼主观症状、角膜感觉、泪膜破裂时间(BUT)、无局部麻醉下的Schirmer试验以及荧光素和丽丝胺绿染色情况。

结果

术后干眼症状主观评分无统计学显著升高。LASEK术后1个月内角膜感觉降低(P<0.05)。1周和1个月时BUT明显降低(P<0.01),Schirmer试验结果无显著变化。角膜荧光素染色中,1周时点状染色更集中(P<0.05)。丽丝胺绿染色在任何随访检查中均未发现显著变化。

结论

准分子激光上皮下角膜磨镶术导致角膜感觉短期降低,并轻微影响眼表和泪膜。LASEK中上皮瓣复位可能对泪膜和眼表因素有积极影响。

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