摘要
目的观察绷带型角膜接触镜对飞秒激光制瓣的LASIK(femtosecond-LASIK,FS-LASIK)的影响。方法选取45例(90眼)近视患者于我院屈光中心行双眼FS-LASIK术,术毕时随机选一眼给予Pure Vision软性绷带型角膜接触镜(戴镜组),并于术后第3天复诊时取出,另一眼作为非戴镜组,不戴角膜接触镜。对比戴镜组与非戴镜组术后1 d、3 d、1周、1个月、3个月的角膜瓣对合情况、主观症状评分。观察戴镜组与非戴镜组术前、术后1周、1个月、3个月的角膜荧光素染色、泪膜破裂时间、基础泪液分泌量、下泪河面积、裂隙灯检查以及术后角膜瓣并发症情况。术前及术后各个时间点角膜荧光素染色评分、泪膜破裂时间、基础泪液分泌量、下泪河面积比较采用重复测量设计的方差分析。结果角膜瓣对合情况:术后1 d时戴镜组优于非戴镜组的比例占总数的66.7%(30例);术后3 d时,戴镜组较好的比例略微下降为64.5%(29例);术后1周后,戴镜组与非戴镜组角膜瓣与基质床交界面差异不明显。术后1周、1个月、3个月时,戴镜组与非戴镜组的泪膜破裂时间、角膜荧光素染色评分、基础泪液分泌量、下泪河面积比较,差异均无统计学意义(均为P>0.05)。术后1 d 18.6%的患者表示配戴绷带镜较为舒适,32.6%认为并不舒适,而48.8%患者未感到明显差异;术后第3天上述主观症状的比例分别为:16.3%、51.2%及32.5%。结论 FS-LASIK术后早期常规配戴绷带型角膜接触镜有助于角膜瓣的贴附,使对合面更加平整和均匀,但在泪膜稳定性方面并没有明显作用。大部分患者并未因配戴绷带镜而有效缓解了主观不适的症状。
Objective To evaluate the effects of bandage contact lenses（BCL） insertion immediately after femtosecond laser assisted laser in situ keratomileusis（FS-LASIK）.Methods In a prospective self-controlled study,90 eyes of 45 patients with myopia were treated with bilateral FS-LASIK.The patients were randomly fitted with a PureVision bandage soft contact lenses in one eye,and nothing in the other eye immediately after LASIK.BCL were removed in the third day after surgery.The interface of corneal flap and stromal bed between the BCL group and without BSL group were compared by RTVue-OCT at 1 day,3 days,1 week,1 month,3 months after surgery.Subjective score,corneal fluorescein staining（FL）,tear film break-up time（BUT）,Schirmer Ⅰ test（S IT）,lower tear meniscus area and incidence of complications related to the corneal flap using slit lamp were also included.The ANOVA for repeat measurements were used for statistical analysis.Results RTVue-OCT was used to investigate the interface of corneal flap and stromal bed,and the results could be divided into 4 types：BCL group was better than without BCL group,BCL group was worse than without BCL group,both was good and both was bad;The proportions were 66.7%（30 cases）,0,28.9%（13 cases）,4.4%（2 cases） at 1 day after surgery,and 64.5%（29 cases）,31.1%（14 cases）,4.4%（2 cases）,0 in 3 days after surgery,and no obvious difference after 1 week between the two group.BUT,FL,S IT,lower tear meniscus area showed no statistically significant difference between the BCL group and without BSL group postoperatively at 1 week,1 month,and 3 months after surgery.At 1 day after surgery,18.6%of patients felt comfort after wearing BCL,whereas 32.6%didn＇t enjoy having a BSCL,the remaining 48.8%felt no difference,which at 3 days after surgery were 16.3%,51.2%and 32.5%.Conclusion Wearing BCL can help attachment of the corneal flap and stromal bed,increasing the smooth and uniform of the interface.But there is no difference in increasing stability of tear film between two groups.The majority of patients don＇t experience better comfort from the application of BCL.
出处
《眼科新进展》
CAS
北大核心
2016年第1期42-46,共5页
Recent Advances in Ophthalmology
关键词
飞秒激光制瓣的LASIK
绷带型角膜接触镜
角膜瓣对合面
下泪河面积
femtosecond laser assisted laser in situ keratomileusis
bandage contact lenses
interface of corneal flap and stromal bed
low er tear meniscus area
作者简介
方雨新，女，1988年9月出生，在读硕士研究生。研究方向：角膜屈光手术。联系电话：13810980899；E—mail：quill_9@163．com
通讯作者：周跃华，E-mail：yh0220@yahoo．com
