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SMILE 术后干眼症。

Dry Eyes After SMILE.

机构信息

Department of Ophthalmology, Tuen Mun Hospital, Hong Kong, China.

Hospital Authority, Hong Kong, China.

出版信息

Asia Pac J Ophthalmol (Phila). 2019 Sep-Oct;8(5):397-405. doi: 10.1097/01.APO.0000580136.80338.d0.

Abstract

Dry eyes is one of the most common complications after laser vision correction. Small incision lenticule extraction (SMILE) is a flapless procedure with a smaller corneal incision, less corneal nerves are transected during, making it theoretically less prone to dry eyes. Both SMILE and femtosecond-laser-assisted in situ keratomileusis (FS-LASIK) induce a transient worsening in dry eye parameters, but there is evidence showing that SMILE holds promises to have fewer negative impacts on the ocular surface parameters and allow an earlier recovery. SMILE-treated eyes may also have shown less corneal denervation and better corneal sensitivity compared with FS-LASIK eyes. This review summarizes the mechanisms of dry eyes after laser vision correction, the short-term (≤6 months) and long-term (>6 months) results in changes to dry eyes signs and symptoms, and corneal sensitivity of SMILE, as compared with FS-LASIK. Limitation of the studies and reasons accounting for their discrepancies will be discussed. Future randomized controlled trials with standardized postoperative regime are needed for better evaluation of dry eyes after SMILE.

摘要

干眼症是激光视力矫正后最常见的并发症之一。小切口微透镜提取术(SMILE)是一种无瓣手术,角膜切口较小,术中切断的角膜神经较少,理论上不太容易引起干眼症。SMILE 和飞秒激光辅助原位角膜磨镶术(FS-LASIK)都会导致干眼症参数的短暂恶化,但有证据表明,SMILE 对眼表参数的负面影响较小,并允许更早恢复。与 FS-LASIK 相比,SMILE 治疗的眼睛可能显示出较少的角膜去神经支配和更好的角膜敏感性。本文综述了激光视力矫正后干眼症的发病机制,以及 SMILE 与 FS-LASIK 相比,在短期(≤6 个月)和长期(>6 个月)对干眼症体征和症状以及角膜敏感性的影响。还讨论了研究的局限性和导致其差异的原因。需要进行未来的随机对照试验,采用标准化的术后方案,以更好地评估 SMILE 术后的干眼症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0e8/6784859/5519ba86a973/ap9-8-397-g001.jpg

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