Nejima Ryohei, Miyata Kazunori, Tanabe Tatsuro, Okamoto Fumiki, Hiraoka Takahiro, Kiuchi Takahiro, Oshika Tetsuro
Meiwakai Medical Foundation, Miyata Eye Hospital, Miyazaki, Japan.
Am J Ophthalmol. 2005 Jan;139(1):64-71. doi: 10.1016/j.ajo.2004.08.039.
To compare corneal sensation, corneal barrier function, tear secretion, and tear film stability after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK).
Prospective, nonrandomized clinical trial.
In a prospective study, 28 eyes of 15 patients underwent PRK and 115 eyes of 59 patients underwent LASIK to correct myopia. Corneal sensation, corneal epithelial barrier function, tear secretion, and tear film stability were examined preoperatively and 1 week and 1, 3, 6, and 12 months postsurgery.
Both PRK and LASIK significantly compromised corneal sensation, increased epithelial barrier function, reduced tear secretion, and deteriorated tear film stability (P < .05, Wilcoxon signed-rank test). Deterioration of corneal sensation was significantly greater after LASIK than after PRK by 3 months postoperatively (P < .05, Wilcoxon rank sum test). Increases in corneal epithelial permeability were more prolonged after LASIK than after PRK. A significant intergroup difference in permeability was observed 1 month after surgery (P < .01). Tear breakup time was significantly shorter in the LASIK group than in the PRK group up to 3 months after surgery (P < .045).
LASIK induces greater and more prolonged damage to corneal sensation, corneal barrier function, and tear film stability than PRK.
比较准分子激光原位角膜磨镶术（LASIK）和准分子激光角膜切削术（PRK）术后的角膜感觉、角膜屏障功能、泪液分泌及泪膜稳定性。
前瞻性、非随机临床试验。
在一项前瞻性研究中，15例患者的28只眼接受了PRK，59例患者的115只眼接受了LASIK以矫正近视。术前及术后1周、1、3、6和12个月检查角膜感觉、角膜上皮屏障功能、泪液分泌及泪膜稳定性。
PRK和LASIK均显著损害角膜感觉，增加上皮屏障功能，减少泪液分泌并使泪膜稳定性变差（P <.05，Wilcoxon符号秩检验）。术后3个月时，LASIK术后角膜感觉的损害比PRK术后显著更严重（P <.05，Wilcoxon秩和检验）。LASIK术后角膜上皮通透性增加的持续时间比PRK术后更长。术后1个月时观察到两组间通透性存在显著差异（P <.01）。术后3个月内，LASIK组的泪膜破裂时间显著短于PRK组（P <.045）。
与PRK相比，LASIK对角膜感觉、角膜屏障功能及泪膜稳定性造成的损害更大且持续时间更长。
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