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目的:探讨准分子激光原位角膜磨镶术(LASIK)后角膜知觉的变化及其对干眼的影响与切削深度的关系。方法:观察上方蒂做瓣的LASIK手术30例(60眼),观察指标包括患者术中切削深度及术前,术后1wk,1mo,3mo的角膜中央知觉、基础泪液分泌量、泪膜破裂时间(BUT)、角膜荧光素钠染色评分、干眼主觉症状评分。结果:术后1wk,1mo角膜知觉敏感度与术前相比差异均非常显著(P<0.01),术后3mo平与术前相比差异无统计学意义(P>0.05);术后1wk患者的主觉症状与术前相比无显著差异(P=0.079>0.05),术后mo时差异显著(P=0.025<0.05),术后3mo时差异极其显著(P=0.001<0.01);患者术后泪流量在术后1wk;1mo时明显低于术前(P<0.01),直至术后3mo仍未恢复至术前水平(P<0.01);术后1wk,1mo,3mo泪膜破裂时间缩短,术后3mo时与术前相比差异显著(P<0.01);角膜荧光素钠染色评分方面,术后1mo时角膜上皮损伤最明显,术后3mo时与术前仍有显著差异(P<0.01)直线回归与相关分析结果,说明在两者之间存在直线相关的关系r=0.798,P<0.01。结论:LASIK术后角膜中央知觉明显下降并随时间延续而逐渐恢复,3mo时与术前无统计学差异;但是干眼的相关指标并未随之恢复至术前水平;术后角膜知觉的下降与术中切削深度间存在正相关。
Objective: To investigate the change of corneal sensitivity after laser in situ keratomileusis (LASIK) and its relationship with dry eye depth and depth of cut. Methods: Thirty patients (60 eyes) underwent LASIK. The observation included the depth of incision and the central corneal sensitivity, basal tear secretion, tear film rupture time before operation, 1wk, 1mo, 3mo postoperation (BUT), corneal sodium fluorescein staining score, dry eye symptoms symptoms score. Results: The sensory sensitivity of cornea at 1wk and 1mo after operation was significantly higher than that before operation (P <0.01), but there was no significant difference between preoperative 3mo and postoperative 3mo (P> 0.05) (P = 0.079> 0.05). There was significant difference between the two groups (P = 0.025 <0.05), and the difference was significant at 3 months after operation (P = 0.001 <0.01) Postoperative tear flow at 1wk after surgery was significantly lower than preoperatively at 1 month (P <0.01), but did not recover to the preoperative level at 3 months after operation (P <0.01); tear film rupture time at 1wk, 1mo and 3mo (P <0.01). The corneal sodium fluorescein staining score showed that the corneal epithelial injury was the most obvious at 1 month after operation, and there was still significant difference at 3 months after operation (P <0.01) linear regression and correlation analysis results show that there is a linear correlation between the two r = 0.798, P <0.01. CONCLUSION: Central corneal sensation decreased significantly after LASIK and gradually recovered with the passage of time. There was no significant difference between preoperative and postoperative LASIK at 3 months. However, the related indexes of dry eye did not return to the preoperative level. The postoperative corneal sensation decreased There is a positive correlation between depth of cut and surgery.