Konomi Keiko, Chen Li-Li, Tarko Rachel S, Scally Amy, Schaumberg Debra A, Azar Dimitri, Dartt Darlene A
Schepens Eye Research Institute, 20 Staniford Street, Boston, MA 02114, USA.
Invest Ophthalmol Vis Sci. 2008 Jan;49(1):168-74. doi: 10.1167/iovs.07-0337.
To determine whether measurable preoperative characteristics predispose patients to chronic dry eye after laser in situ keratomileusis (LASIK).
The study consisted of 24 eyes of 24 patients who underwent LASIK. Tear breakup time, Schirmer testing with and without anesthesia, rose bengal staining, central corneal sensitivity, nucleus-to-cytoplasmic ratio, and goblet cell density were evaluated 2 weeks before and 1 week, 3 months, and 9 months after surgery. Patients were classified into two outcome groups, the nondry-eye group (NDEG) and the chronic dry-eye group (CDEG), on the basis of dry eye status 9 months after surgery. The authors tested whether preoperative values of each parameter were associated with the development of chronic dry eye.
All parameters, except rose bengal staining, deteriorated significantly after surgery but returned to preoperative levels within 3 to 9 months. The CDEG had significantly lower preoperative Schirmer test values with and without anesthesia and were delayed in recovery after surgery in goblet cell density, rose bengal staining, Schirmer test values without anesthesia, and tear breakup time. Results of preoperative Schirmer tests without anesthesia positively correlated with tear breakup time 9 months after surgery.
Preoperative tear volume may affect recovery of the ocular surface after LASIK and may increase the risk for chronic dry eye.
确定术前可测量的特征是否使患者在准分子原位角膜磨镶术（LASIK）后易患慢性干眼。
该研究纳入了24例行LASIK手术的患者的24只眼。在手术前2周以及术后1周、3个月和9个月评估泪膜破裂时间、有无麻醉情况下的泪液分泌试验、孟加拉玫瑰红染色、中央角膜敏感性、细胞核与细胞质比率以及杯状细胞密度。根据术后9个月的干眼状态，将患者分为两个结果组，即非干眼组（NDEG）和慢性干眼组（CDEG）。作者测试了每个参数的术前值是否与慢性干眼的发生有关。
除孟加拉玫瑰红染色外，所有参数在术后均显著恶化，但在3至9个月内恢复到术前水平。慢性干眼组在有无麻醉情况下的术前泪液分泌试验值均显著较低，并且在术后杯状细胞密度、孟加拉玫瑰红染色、无麻醉情况下的泪液分泌试验值和泪膜破裂时间的恢复方面延迟。术前无麻醉情况下的泪液分泌试验结果与术后9个月的泪膜破裂时间呈正相关。
术前泪液量可能影响LASIK术后眼表的恢复，并可能增加慢性干眼的风险。
