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准分子原位角膜磨镶术、准分子激光上皮下角膜磨镶术和机械法准分子激光上皮瓣下角膜磨镶术后的干眼疾病:一项观察性横断面研究

Dry Eye Disease following LASIK, PRK, and LASEK: An Observational Cross-Sectional Study.

作者信息

Yahalomi Tal, Achiron Asaf, Arnon Roee, Stanescu Nir, Pikkel Joseph

机构信息

Department of Ophthalmology, Samson Assuta Ashdod Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashdod 7747629, Israel.

Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6423906, Israel.

出版信息

J Clin Med. 2023 May 30;12(11):3761. doi: 10.3390/jcm12113761.

Abstract

Dry eye disease is the most frequent non-refractive postoperative complication following refractive surgery. This prospective study investigated the development of dry eye disease after three common refractive laser surgeries: laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and laser-assisted sub-epithelial keratectomy (LASEK). Patients who underwent uneventful refractive surgery in a single private medical center between May 2017 and September 2020 were included. Ocular surface disease was graded according to the Dry Eye Workshop severity (DEWS) classification. Patients were examined 6 months following refractive surgery. The analysis included 251 eyes of 137 patients: 64 eyes (36 patients) after LASEK, 90 eyes (48 patients) after PRK, and 97 eyes (53 patients) after LASIK. At 6 months post-surgery, the DEWS score was higher for the LASIK than the PRK and LASEK groups ( = 0.01). For the total cohort, severe DEWS score (grades 3 and 4) at 6 months post-surgery was correlated with female gender ( = 0.01) and to the amount of refractive correction ( < 0.001), but not to age ( = 0.87). In conclusion, LASIK surgery and female gender were associated with dry eye. Patients, particularly those with high myopia, should be counseled about the risk of developing dry eye after refractive surgeries.

摘要

干眼是屈光手术后最常见的非屈光性术后并发症。这项前瞻性研究调查了三种常见屈光性激光手术后干眼的发生情况:准分子原位角膜磨镶术(LASIK)、准分子激光角膜切削术(PRK)和准分子激光上皮下角膜磨镶术(LASEK)。纳入了2017年5月至2020年9月期间在一家私立医疗中心顺利接受屈光手术的患者。根据干眼研讨会严重程度(DEWS)分类对眼表疾病进行分级。屈光手术后6个月对患者进行检查。分析包括137例患者的251只眼:LASEK术后64只眼(36例患者),PRK术后90只眼(48例患者),LASIK术后97只眼(53例患者)。术后6个月,LASIK组的DEWS评分高于PRK组和LASEK组(P = 0.01)。对于整个队列,术后6个月严重DEWS评分(3级和4级)与女性性别(P = 0.01)和屈光矫正量(P < 0.001)相关,但与年龄无关(P = 0.87)。总之,LASIK手术和女性性别与干眼有关。应向患者,尤其是高度近视患者,告知屈光手术后发生干眼的风险。

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