目的 :探讨准分子激光原位角膜磨镶术 (LASIK)角膜瓣蒂置于上方位与鼻侧位术后干眼症的差异。方法 :随机选LASIK手术角膜瓣蒂置于上方位 176只眼 ,鼻侧位 185只眼。分别于术后 1日、1周、1个月和 3个月测定记录泪液分泌(Schirmer 1)和泪膜破裂时间 (BUT)。结果 :手术后 1日和 3个月两组 ,Schirmer 1实验和BUT无明显差异 (P >0 0 5 ) ,术后 1周和术后 1个月两组Schirmer 1实验和BUT结果有明显差异 (P <0 0 5 )。旋转刀组术后 1周和 1个月分别有 4 6只眼 (占2 6 1% )和 6 8只眼 (占 38 6 % )符合干眼症的诊断 ,而平推刀术后 1周和 1个月分别有 12只眼 (占 6 5 % )和 38只眼 (占2 0 5 % )符合干眼症的诊断。结论 :角膜瓣蒂位于上方位术后干眼症发生率高于鼻侧位 Objective: To investigate the difference of dry eye after laser in situ keratomileusis (LASIK) between corneal flap pedicle and nasal position. Methods: LASIK surgery was performed on 176 corneal flap pedicles and 185 eyes on the nasal side. The tear secretion (Schirmer 1) and tear film breakup time (BUT) were recorded at 1 day, 1 week, 1 month and 3 months postoperatively. Results: There was no significant difference between Schirmer 1 test and BUT (P> 0.05) at 1 and 3 months after surgery. The results of Schirmer 1 and BUT at 1 week and 1 month after operation were significantly different (P <0 05). In the rotary knife group, 46 eyes (261%) and 68 eyes (386%) were diagnosed with dry eye at 1 week and 1 month after surgery respectively, And 12 eyes (65%) and 38 eyes (25%) respectively in one month were consistent with the diagnosis of dry eye. Conclusion: The incidence of dry eye is higher than that of the nasal side after the flap of the flap is located on the upper side