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飞秒激光小切口角膜基质内透镜取出术与飞秒LASIK术后干眼和角膜神经修复的比较分析 预览

Comparison of dry-eye and corneal nerves recovery between small incision lenticule extraction surgery and femtosecondlaser in situ keratomileusissurgery
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摘要 目的探讨飞秒激光小切口角膜基质内透镜取出术(SMILE)与LASIK术后干眼与角膜知觉变化。方法共纳入56例符合常规近视手术适应证的患者为研究对象,随机分为SMULE组和飞秒LASIK组各28例(28眼),其中双眼接受同一手术患者,随机选取1眼纳入统计分析;单眼手术者,术眼入组。分别比较两组患者术前,术后1周、1月、3月和6月眼表疾病指数(OSDI)、泪膜破裂时间(BUT)及泪液分泌试验(SIT);利用Cochet-Bonnet角膜知觉仪于上述测量时间,比较角膜中央、上方、下方、颞侧、鼻侧的角膜知觉。结果两组患者术后OSDI值增加,但在术后1个月时恢复至术前水平,差异有统计学意义(P〈0.05)。两组BUT值较术前均显著下降,SMILE组患者术后1个月和6个月BUT值均显著低于对照组,差异有统计学意义(P〈0.05)。两组患者SIT值较术前下降,但两组比较差异无统计学意义(P〉0.05)。SMILE患者术后角膜下方、鼻侧和颞侧角膜知觉较其他2个区域恢复更快,飞秒LASIK组患者至术后6个月随访时间时,所有测量区角膜知觉均未恢复至术前水平。结论两种不同神经修复功能差异不大,SMILE对角膜神经纤维创伤低于LASIK术。 Objective To compare the changes of dry-eye and corneal nerves recovery after the small incision lenticule extraction surgery(SMILE) and femtosecond laser in situ keratomileusis(femto-LASIK).Methods The femtosecond group and the mechanical microkeratome group comprised 28 eyes(28 patients)respectively,one eye per individual included in analysis.Ocular Surface) Disease) Index(OSDI),Tear film breakup time(BUT),Schirmer test without anesthesia(S1T) and corneal fluorescein staining were evaluated before surgery and at 1 week,1 month,3 months,and 6 months after surgery.Evaluated the changes of BUT and S1 T in the different period after SMILE or femto-LASIK procedure,and compared the changes of corneal sensitivity between the two groups.The corneal perception of the central,superior,inferior,temporal and nasal side of the cornea was compared with the Cochet-Bonnet corneal perception instrument.Results OSDI scores in both groups were increased immediately and returned to preoperative level at 1 month after surgeries,while BUT scores decreased significantly.Patients in SMILE group were less likely to have corneal staining compared with those in the femto-LASIK group(P〈0.05).Corneal sensitivity at any site was decreased at all postoperative time points in both groups at 6 months postoperatively(P〈0.05).There was no significant correlation between the SIT refraction,ablation depth(P〉0.05).SMILE patients with postoperative corneal inferior,nasal and temporal side corneal sensation than the other 2 regions faster recovery,femtosecond LASIK group to 6 months of follow-up time,all the measurement area of corneal sensation were not restored to the preoperative level.Conclusions There is no significant difference between the two kinds of nerve repair,and SMILE is less than LASIK in the injury of corneal nerve fibers.
作者 蔡劲锋 王敏 毛凯波 芮艳君 石昌盛 董卫文 Cai Jingfeng, et al. (Shanghai Aier Eye Hospital, Shanghai 200336, China)
出处 《齐齐哈尔医学院学报》 2016年第36期4503-4505,共3页 Journal of Qiqihar Medical College
基金 上海市卫生局科研项目(20114124)
关键词 角膜 干眼 飞秒激光小切口基质内透镜取出术 Dry eye Cornea Small incision lenticule extraction surgery
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