Smile Eye Clinic, Yokohama, Japan.
Jpn J Ophthalmol. 2012 May;56(3):208-13. doi: 10.1007/s10384-012-0125-8. Epub 2012 Feb 23.
To evaluate the efficacy of punctal plugs for patients with post-LASIK dry eye.
A prospective study was conducted on 25 eyes of 18 patients who underwent LASIK. All eyes fulfilled the Japanese dry-eye criteria and had not responded to conventional treatment with artificial tears by 1 month postsurgery. They were randomly divided into a plug and a non-plug group. Punctal plugs were inserted into the superior and inferior puncta in the plug group after the 1-month examination. Uncorrected and best corrected visual acuity (UCVA, BCVA), refraction, functional visual acuity (FVA) after 10 s eye opening (FVA 10), surface regularity index (SRI) after 10 s eye opening (SRI 10), corneal sensitivity, Schirmer test, fluorescein staining (FS), tear break-up time (TBUT), and symptoms were compared between the groups 1 and 3 months postsurgery. Changes in these data from 1 to 3 months were also compared between the groups.
The values in SRI 10, FS, and TBUT were significantly better in the plug group at 3 months. Changes in the values of UCVA, FVA 10, FS, TBUT, and symptoms between 1 and 3 months improved significantly in the plug group compared with the non-plug group.
Our results suggest that punctal occlusion for both puncta is effective for patients with post-LASIK dry eye that cannot be controlled by artificial tears alone. Punctal plugs can improve not only the symptoms and tear function, but also the quality of vision, for example FVA.
评估针对 LASIK 术后干眼症患者行泪点塞治疗的疗效。
前瞻性研究共纳入 18 例 25 眼患者,均为 LASIK 术后患者。所有患者均符合日本干眼标准,且术后 1 个月时经人工泪液常规治疗后无改善。患者随机分为塞栓组和非塞栓组。塞栓组在术后 1 个月检查时于上下泪点行泪点塞治疗。比较两组患者术后 1 个月和 3 个月时的裸眼视力(UCVA)、最佳矫正视力(BCVA)、屈光度、睁眼 10 s 时的视力(FVA 10)、睁眼 10 s 时的表面规则指数(SRI 10)、角膜敏感度、Schirmer 试验、荧光素染色(FS)、泪膜破裂时间(TBUT)和症状。同时比较两组患者术后 1 个月至 3 个月各项指标的变化。
塞栓组患者术后 3 个月时的 SRI 10、FS 和 TBUT 值显著优于非塞栓组。与非塞栓组相比,塞栓组患者术后 1 个月至 3 个月期间的 UCVA、FVA 10、FS、TBUT 和症状变化均明显改善。
我们的研究结果表明,对于单独应用人工泪液无法控制的 LASIK 术后干眼症患者,行双侧泪点塞治疗是有效的。泪点塞不仅能改善症状和泪液功能,还能提高视力质量,如 FVA。