De Paiva Cintia S, Chen Zhuo, Koch Douglas D, Hamill M Bowes, Manuel Francis K, Hassan Sohela S, Wilhelmus Kirk R, Pflugfelder Stephen C
Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin Street, NC 205, Houston, TX 77030, USA.
Am J Ophthalmol. 2006 Mar;141(3):438-45. doi: 10.1016/j.ajo.2005.10.006.
To determine the incidence of dry eye and its risk factors after myopic laser-assisted in situ keratomileusis (LASIK).
Single-center, prospective randomized clinical trial of 35 adult patients, aged 24 to 54 years, with myopia undergoing LASIK.
setting and study population: Participants were randomized to undergo LASIK with a superior or a nasal hinge flap. They were evaluated at 1 week and 1, 3, and 6 months after surgery. intervention: Bilateral LASIK with either a superior-hinge Hansatome microkeratome (n = 17) or a nasal-hinge Amadeus microkeratome (n = 18). main outcome measures: The criterion for dry eye was a total corneal fluorescein staining score > or =3. Visual acuity, ocular surface parameters, and corneal sensitivity were also analyzed. Cox proportional-hazard regression was used to assess rate ratios (RRs) with 95% confidence intervals.
The incidence of dry eye in the nasal- and superior-hinge group was eight (47.06%) of 17 and nine (52.94%) of 17 at 1 week, seven (38.89%) of 18 and seven (41.18%) of 17 at 1 month, four (25%) of 16 and three (17.65%) of 17 at 3 months, and two (12.50%) of 16 and six (35.29%) of 17 at 6 months, respectively. Dry eye was associated with level of preoperative myopia (RR 0.88/each diopter, P = .04), laser-calculated ablation depth (RR 1.01/microm, P = 0.01), and combined ablation depth and flap thickness (RR 1.01/microm, P = 0.01).
Dry eye occurs commonly after LASIK surgery in patients with no history of dry eye. The risk of developing dry eye is correlated with the degree of preoperative myopia and the depth of laser treatment.
确定近视激光原位角膜磨镶术（LASIK）后干眼的发生率及其危险因素。
对35例年龄在24至54岁、患有近视且接受LASIK手术的成年患者进行单中心前瞻性随机临床试验。
设置与研究人群：参与者被随机分为接受上方铰链瓣或鼻侧铰链瓣的LASIK手术。在术后1周、1个月、3个月和6个月对他们进行评估。干预措施：使用上方铰链的Hansatome微型角膜刀（n = 17）或鼻侧铰链的Amadeus微型角膜刀（n = 18）进行双侧LASIK手术。主要观察指标：干眼的标准为角膜荧光素染色总分≥3分。还分析了视力、眼表参数和角膜敏感性。采用Cox比例风险回归分析评估率比（RRs）及95%置信区间。
鼻侧铰链组和上方铰链组干眼的发生率分别为：术后1周时，17例中有8例（47.06%）和17例中有9例（52.94%）；术后1个月时，18例中有7例（38.89%）和17例中有7例（41.18%）；术后3个月时，16例中有4例（25%）和17例中有3例（17.65%）；术后6个月时，16例中有2例（12.50%）和17例中有6例（35.29%）。干眼与术前近视度数（RR 0.88/每屈光度，P = 0.04）、激光计算的切削深度（RR 1.01/微米，P = 0.01）以及切削深度与瓣厚度之和（RR 1.01/微米，P = 0.01）相关。
无干眼病史的患者在LASIK手术后干眼很常见。发生干眼的风险与术前近视程度和激光治疗深度相关。
