Ocular Surface Center, Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77098, USA.
Ocul Surf. 2010 Jul;8(3):135-45. doi: 10.1016/s1542-0124(12)70224-0.
Symptoms of tear dysfunction after laser in situ keratomileusis (LASIK) occur in nearly all patients and resolve in the vast majority. Although dry eye complaints are a leading cause of patient discomfort and dissatisfaction after LASIK, the symptoms are not uniform, and the disease is not a single entity. Post-LASIK tear dysfunction syndrome or dry eye is a term used to describe a spectrum of disease encompassing transient or persistent post-operative neurotrophic disease, tear instability, true aqueous tear deficiency, and neuropathic pain states. Neural changes in the cornea and neuropathic causes of ocular surface discomfort may play a separate or synergistic role in the development of symptoms in some patients. Most cases of early post-operative dry eye symptoms resolve with appropriate management, which includes optimizing ocular surface health before and after surgery. Severe symptoms or symptoms persisting after 9 months rarely respond satisfactorily to traditional treatment modalities and require aggressive management. This review covers current theories of post-LASIK dry eye disease, pathophysiology, risk factors, and management options for this disease spectrum of post-LASIK tear dysfunction and neuropathic pain.
激光原位角膜磨镶术 (LASIK) 后泪液功能障碍的症状几乎出现在所有患者中，且绝大多数患者的症状会缓解。虽然干眼症是 LASIK 术后引起患者不适和不满的主要原因，但症状并不统一，疾病也不是单一实体。LASIK 术后泪液功能障碍综合征或干眼症是一个术语，用于描述一系列疾病，包括短暂或持续的术后神经营养性疾病、泪液不稳定、真性泪液缺乏和神经病理性疼痛状态。角膜的神经变化和眼表不适的神经原因可能在某些患者的症状发展中发挥单独或协同作用。大多数术后早期干眼症状可通过适当的治疗得到缓解，包括在手术前后优化眼表健康。严重症状或术后 9 个月后持续存在的症状很少对传统治疗方法有满意的反应，需要积极治疗。本综述涵盖了 LASIK 术后干眼的当前理论、病理生理学、风险因素以及针对该 LASIK 术后泪液功能障碍和神经病理性疼痛疾病谱的治疗选择。
