發(fā)布時(shí)間：2018-12-12 04:52

【摘要】：目的:探討LASIK術(shù)后淚膜及角膜地形圖的早期改變,研究淚膜變化及其與角膜地形圖改變的關(guān)系及LASIK術(shù)后干眼的原因,指導(dǎo)LASIK術(shù)后治療。 方法:選擇2010年4月至2010年10月期間在我院近視治療中心行LASIK手術(shù)的患者62例(120只眼,其中有4例為單眼手術(shù))分別于術(shù)前、術(shù)后1周、1月、3月、6月詢問患者干眼的主觀癥狀并常規(guī)檢查裸眼視力,裂隙燈檢查角膜瓣情況,同時(shí)行角膜地形圖(Humphrey ATLAS Corneal Topography Systems)檢查角膜不規(guī)則指數(shù)(Corneal Irregularity Measurement,CIM)、角膜形態(tài)因素(Shape Factor, SF),角膜熒光素染色、淚膜破裂時(shí)間(Tear Break Up Time, BUT)及Schirmer I試驗(yàn)(Schirmer I test, SIt)。 結(jié)果:LASIK術(shù)后1周、1月、3月干眼癥狀較術(shù)前加重(P0.01),術(shù)后6月基本恢復(fù)(P=0.3930.05)。角膜熒光素染色術(shù)后術(shù)后1周、1月、3月較術(shù)前加重(P0.05),術(shù)后6月基本恢復(fù)P=0.3830.05。SIt值于術(shù)后1周、1月、3月較術(shù)前均減少(P0.01),但術(shù)后6月時(shí)基本恢復(fù)(P=0.7040.05)。BUT術(shù)后1周、1月、3月、6月與術(shù)前相比縮短(P0.01),6月尚未恢復(fù)。CIM值術(shù)后1周、1月、3月、6月較術(shù)前增加(P0.01)。SF值術(shù)后1周、1月、3月、6月較術(shù)前增加(P0.01)。LASIK術(shù)后BUT及CIM存在冪函數(shù)負(fù)相關(guān)關(guān)系,相關(guān)系數(shù)為r=0.393。BUT與SF有直線正相關(guān)關(guān)系,相關(guān)系數(shù)為r=0.436。SIt與CIM存在三次模型相關(guān)關(guān)系,相關(guān)系數(shù)為r=0.320。 結(jié)論:LASIK術(shù)后患者眼干癥狀加重,術(shù)后1周、1月、3月淚液分泌量減少,明顯低于術(shù)前水平,術(shù)后6月時(shí)基本恢復(fù)。淚膜穩(wěn)定性也受到破壞,6月時(shí)仍未恢復(fù)。LASIK手術(shù)會(huì)導(dǎo)致角膜不規(guī)則性增加及角膜形態(tài)改變,術(shù)后1周增加明顯,6月時(shí)仍未完全恢復(fù),淚膜穩(wěn)定性下降與LASIK術(shù)后角膜不規(guī)則性增加及角膜形態(tài)改變相關(guān)。
[Abstract]:Objective: to investigate the early changes of tear film and corneal topography after LASIK, to study the relationship between the changes of tear film and corneal topography and the causes of dry eye after LASIK, and to guide the treatment after LASIK. Methods: from April 2010 to October 2010, 62 patients (120 eyes, 4 of whom underwent monocular surgery) underwent LASIK operation in our myopia treatment center, one week, one month and three months after operation, respectively. In June, patients were asked about the subjective symptoms of the dry eye and their visual acuity was examined routinely. Slit lamp was used to examine the corneal flap. Meanwhile, corneal topography (Humphrey ATLAS Corneal Topography Systems) was performed to examine the corneal irregular index (Corneal Irregularity Measurement,CIM), corneal morphological factor (Shape Factor,). SF), cornea fluorescein staining, tear film rupture time (Tear Break Up Time, BUT) and Schirmer I test (Schirmer I test, SIt). Results: the symptoms of dry eye in 1 week, 1 month and 3 months after LASIK were more serious than those before operation (P0.01), and basically recovered at 6 months after LASIK (P0. 3930.05). Corneal fluorescein staining after 1 week, 1 month, 3 months compared with the preoperative aggravated (P0.05), 6 months after the basic recovery of P=0.3830.05.SIt in the postoperative 1 week, 1 month, 3 months compared with the preoperative decreased (P0.01), But at 6 months after operation, it recovered basically (P < 0. 704 0. 05). BUT, 1 week, 1 month, 3 months, 6 months compared with pre operation (P0. 01). CIM value was 1 week, 1 month, 3 months after operation, P < 0. 01, P 0. 01, P 0. 01). There was a negative correlation between BUT and CIM after P0.01). LASIK. The correlation coefficient was that there was a linear positive correlation between r=0.393.BUT and SF. The correlation coefficient between r=0.436.SIt and CIM is cubic, and the correlation coefficient is 0.320. Conclusion: the dry eye symptoms of LASIK patients were aggravated and the amount of tear secretion decreased at 1 week, 1 month and 3 months after operation, which was significantly lower than that before operation, and recovered basically at 6 months after operation. The stability of lacrimal film was also damaged, and it was still not recovered at 6 months. LASIK operation resulted in the increase of corneal irregularity and corneal morphology, the increase was obvious at 1 week after operation, and the recovery was not complete at 6 months. The decrease of tear film stability was related to the increase of corneal irregularity and corneal morphology after LASIK.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R779.63

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