中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2014年
9期
532-536
,共5页
干眼病%飞秒激光小切口基质透镜取出术%飞秒激光%角膜磨镶术,激光原位%体层摄影术,光学相干
榦眼病%飛秒激光小切口基質透鏡取齣術%飛秒激光%角膜磨鑲術,激光原位%體層攝影術,光學相榦
간안병%비초격광소절구기질투경취출술%비초격광%각막마양술,격광원위%체층섭영술,광학상간
Xerophthalmia%Small incision lenticule extraction%Femtosecond laser%Keratomileusis,laser in situ%Tomography,optical coherence
目的 比较SMILE、飞秒激光制瓣LASIK(FS-LAISK)以及机械法去瓣LASIK(Epi-LASIK)手术前后不同时间点干眼参数的变化情况,探讨不同手术方式对泪膜的影响.方法 前瞻性病例对照研究.行SMILE者(SMILE组)33例(66眼),行FS-LAISK者(FS-LAISK组)24例(48眼),行Epi-LASIK者(Epi-LASIK组)31例(61眼).分别在术前、术后1周、1个月、3个月、6个月采用眼前节OCT测量患者的泪河高度(TMH)、泪膜破裂时间(BUT)、基础泪液分泌量(SIT).不同组别一般资料及干眼参数的比较采用单因素方差分析,同一组内手术前后的比较采用重复测量方差分析.结果 SMILE组术后各时间点TMH与术前相比,差异均无统计学意义(F=1.225,P＞0.05);FS-LASIK组TMH在术后1个月内较术前降低,差异有统计学意义,并于术后3个月逐渐恢复(F=3.806,P＜0.05);Epi-LASIK组TMH在术后3个月内较术前下降,差异有统计学意义,直至术后6个月恢复术前水平(F=4.564,P＜0.05).术后各时间点,3组间TMH差异均有统计学意义(F=4.749、8.173、3.850、2.830,P＜0.05).SMILE组和FS-LASIK组BUT在术后3个月内,与术前相比差异有统计学意义,并在术后6个月恢复至术前水平(F=2.860、3.590,P＜0.05).Epi-LASIK组术后各时间点的BUT较术前降低,差异有统计学意义(F=12.800,P＜0.01).3组间BUT在术前、术后1周及术后1个月差异均无统计学意义(F=0.966、0.115、0.991,P＞0.05),而术后3、6个月,3组间BUT差异有统计学意义(F=4.448、6.634,P＜0.05).SMILE组和FS-LASIK组SIT在术后1周、1个月均较术前降低,且差异有统计学意义,并于术后3个月恢复至术前水平(F=14.160、13.323,P＜0.01);EPi-LASIK直至术后6个月才恢复至术前水平(F=10.085,P＜0.01).除术后3个月外(F=10.021,P＜0.01),术后其余时间点3组间SIT差异无统计学意义(F=0.005、2.210、1.054,P＞0.05).结论 3种屈光手术后早期均会出现不同程度的干眼参数改变.SMILE术后干眼参数最佳,恢复最快.
目的 比較SMILE、飛秒激光製瓣LASIK(FS-LAISK)以及機械法去瓣LASIK(Epi-LASIK)手術前後不同時間點榦眼參數的變化情況,探討不同手術方式對淚膜的影響.方法 前瞻性病例對照研究.行SMILE者(SMILE組)33例(66眼),行FS-LAISK者(FS-LAISK組)24例(48眼),行Epi-LASIK者(Epi-LASIK組)31例(61眼).分彆在術前、術後1週、1箇月、3箇月、6箇月採用眼前節OCT測量患者的淚河高度(TMH)、淚膜破裂時間(BUT)、基礎淚液分泌量(SIT).不同組彆一般資料及榦眼參數的比較採用單因素方差分析,同一組內手術前後的比較採用重複測量方差分析.結果 SMILE組術後各時間點TMH與術前相比,差異均無統計學意義(F=1.225,P＞0.05);FS-LASIK組TMH在術後1箇月內較術前降低,差異有統計學意義,併于術後3箇月逐漸恢複(F=3.806,P＜0.05);Epi-LASIK組TMH在術後3箇月內較術前下降,差異有統計學意義,直至術後6箇月恢複術前水平(F=4.564,P＜0.05).術後各時間點,3組間TMH差異均有統計學意義(F=4.749、8.173、3.850、2.830,P＜0.05).SMILE組和FS-LASIK組BUT在術後3箇月內,與術前相比差異有統計學意義,併在術後6箇月恢複至術前水平(F=2.860、3.590,P＜0.05).Epi-LASIK組術後各時間點的BUT較術前降低,差異有統計學意義(F=12.800,P＜0.01).3組間BUT在術前、術後1週及術後1箇月差異均無統計學意義(F=0.966、0.115、0.991,P＞0.05),而術後3、6箇月,3組間BUT差異有統計學意義(F=4.448、6.634,P＜0.05).SMILE組和FS-LASIK組SIT在術後1週、1箇月均較術前降低,且差異有統計學意義,併于術後3箇月恢複至術前水平(F=14.160、13.323,P＜0.01);EPi-LASIK直至術後6箇月纔恢複至術前水平(F=10.085,P＜0.01).除術後3箇月外(F=10.021,P＜0.01),術後其餘時間點3組間SIT差異無統計學意義(F=0.005、2.210、1.054,P＞0.05).結論 3種屈光手術後早期均會齣現不同程度的榦眼參數改變.SMILE術後榦眼參數最佳,恢複最快.
목적 비교SMILE、비초격광제판LASIK(FS-LAISK)이급궤계법거판LASIK(Epi-LASIK)수술전후불동시간점간안삼수적변화정황,탐토불동수술방식대루막적영향.방법 전첨성병례대조연구.행SMILE자(SMILE조)33례(66안),행FS-LAISK자(FS-LAISK조)24례(48안),행Epi-LASIK자(Epi-LASIK조)31례(61안).분별재술전、술후1주、1개월、3개월、6개월채용안전절OCT측량환자적루하고도(TMH)、루막파렬시간(BUT)、기출루액분비량(SIT).불동조별일반자료급간안삼수적비교채용단인소방차분석,동일조내수술전후적비교채용중복측량방차분석.결과 SMILE조술후각시간점TMH여술전상비,차이균무통계학의의(F=1.225,P＞0.05);FS-LASIK조TMH재술후1개월내교술전강저,차이유통계학의의,병우술후3개월축점회복(F=3.806,P＜0.05);Epi-LASIK조TMH재술후3개월내교술전하강,차이유통계학의의,직지술후6개월회복술전수평(F=4.564,P＜0.05).술후각시간점,3조간TMH차이균유통계학의의(F=4.749、8.173、3.850、2.830,P＜0.05).SMILE조화FS-LASIK조BUT재술후3개월내,여술전상비차이유통계학의의,병재술후6개월회복지술전수평(F=2.860、3.590,P＜0.05).Epi-LASIK조술후각시간점적BUT교술전강저,차이유통계학의의(F=12.800,P＜0.01).3조간BUT재술전、술후1주급술후1개월차이균무통계학의의(F=0.966、0.115、0.991,P＞0.05),이술후3、6개월,3조간BUT차이유통계학의의(F=4.448、6.634,P＜0.05).SMILE조화FS-LASIK조SIT재술후1주、1개월균교술전강저,차차이유통계학의의,병우술후3개월회복지술전수평(F=14.160、13.323,P＜0.01);EPi-LASIK직지술후6개월재회복지술전수평(F=10.085,P＜0.01).제술후3개월외(F=10.021,P＜0.01),술후기여시간점3조간SIT차이무통계학의의(F=0.005、2.210、1.054,P＞0.05).결론 3충굴광수술후조기균회출현불동정도적간안삼수개변.SMILE술후간안삼수최가,회복최쾌.
Objective To investigate the changes in dry eye parameters after small incision lenticule extraction (SMILE),femtosecond LASIK (FS-LASIK) and off-flap epipolis LASIK (Epi-LASIK),and to investigate the effect of the type of surgery on tear film.Methods In this prospective case-control study,66 eyes of 33 patients underwent SMILE,48 eyes of 24 patients underwent FS-LASIK,and 61 eyes of 31 patients underwent Epi-LASIK.Tear meniscus height (TMH) measured by anterior segment optical coherence tomography (OCT),break-up time (BUT) and Schirmer Ⅰ test (SIT) were evaluated preoperatively,and at 1 week and 1,3,and 6 months postoperatively.Differences in preoperative general information and dry eye parameters among the different groups were performed using a one-way ANOVA.Repeat measures ANOVA was used for preoperative and postoperative comparisons within the same group.Results The TMH results presented no significant decrease at all postoperative time points in the SMILE group (F=1.225,P＞0.05).The TMH results in the FS-LASIK group decreased significantly within 1 month after surgery and returned to preoperative levels at 3 months postoperatively (F=3.806,P＜0.05).The TMH results in the Epi-LASIK group decreased significantly within 3 months after surgery and did not return to preoperative levels until 6 months postoperatively (F=4.564,P＜0.05).There were significant differences in the TMH among the 3 groups after surgery (F=4.749,8.173,3.850,2.830,P＜0.05).The BUT values in the SMILE and FS-LASIK groups decreased significantly within 3 months after surgery,and recovered to their preoperative levels at 6 months postoperatively (F=2.860,3.590,P＜0.05).The BUT values at the postoperative time points were obviously lower than preoperative levels in the Epi-LASIK group (F=12.800,P＜0.01).Differences in the BUT values among the 3 groups were not statistically significant preoperatively and at 1 week and 1 month postoperatively (F=0.966,0.115,0.991,P＞0.05) except for postoperative 3 and 6 months (F=4.448,6.634,P＜0.05).The SIT values in the SMILE and FS-LASIK groups decreased significantly within 1 month after surgery,and recovered to their preoperative levels at 3 months postoperatively (F=14.160,13.323,P＜0.01).The SIT values in the EPi-LASIK group recovered to their preoperative levels at 6 months postoperatively (F=10.085,P＜0.01).There were no statistically significant differences in SIT at all postoperative time points among the 3 groups (F=0.005,2.210,1.054,P＞0.05) except 3 months postoperatively (F=10.021,P＜0.01).Conclusion The three refractive surgery techniques can result in different degrees of short-term dry eye.The dry eye parameters are best in the SMILE group and have the fastest recovery.
