摘要
背景目前干眼发病率较高，干眼患者泪膜不稳定可严重影响飞秒激光辅助角膜原位磨镶术（FS-LASIK）术后术眼的视觉质量。以往泪膜和视觉质量检测方法的局限性影响了FS-LASIK术后视觉质量的预期。采用客观定量的泪膜稳定性和视觉质量检测方法，术前及时改善早期干眼患者的泪膜稳定性具有重要的临床意义。目的探讨FS-LASIK手术前后术眼泪膜质量对客观视觉质量的影响。方法采用前瞻性队列研究方法，于2015年8-12月在南京市第一医院纳入符合常规手术适应证、术前矫正视力≥5．0的近视患者120例120眼，术前客观散射指数（OSI）值均〈1．2。按照《干眼临床诊疗专家共识（2013年）》中关于轻度干眼的诊断标准和检查结果将患者分为轻度干眼组71眼和非干眼组49眼，2个组间人口基线特征匹配。非干眼组术眼接受FS-LASIK，轻度干眼组使用质量分数0．1％玻璃酸钠滴眼液点眼1个月后接受FS—LASIK。所有患者于术前及术后1、3、6、12个月行裂隙灯显微镜、裸眼视力（UCVA）、最佳矫正视力（BCVA）、等效球镜度（sE）、基础泪液分泌试验（sIt）、泪膜破裂时间（BUT）检查并评价术眼安全指数和有效指数；采用OQAS“Ⅱ客观视觉质量分析系统测定调制传递函数截止频率（MTFcutoff）和OSI。结果非干眼组和轻度干眼组术眼的安全指数分别为1．05±0．11和1．03±O．09，有效指数分别为1．02~0．14和1．0l±0．12，差异均无统计学意义（t=0．391、0．147，均P〉0．05）；非干眼组和轻度干眼组术眼术后1个月和3个月BUT较术前均明显缩短，术后6个月恢复至术前水平，轻度干眼组术眼术后3个月BUT值明显低于非干眼组，差异均有统计学意义（均P〈O．05）；术后1、3和6个月非干眼组和轻度干眼组术眼平均OSI值较术前明显增加，同时间点轻度干眼组术眼平均OSI值明显高于非�
Background The instability of tear film in dry eye often affects the visual quality after femtosecond laser-assisted laser in situ keratomileusis （FS-LASIK）. The prediction for visual quality following FS- LASIK was difficult in the past because of the limiting of examination method. OQAS-II is a quantitative checking system of visual quality, which is helpful for the evaluation of the relationship between tear stability and visual quality following FS-LASIK. Objective This study was to investigate the predicting effects of the quality of tear film on visual quality after LASIK. Methods A prospective cohort study was performed. One hundred and twenty eyes of 120 myopic patients who wanted to receive FS-LASIK were enrolled in Nanjing First Hospital from August to December 2015 after informed consent. The objective scattering index （OSI） was 1.2 in the patients. The patients were divided into mild dry eye group （71 eyes） and non-dry eye group （4-9 eyes） based on the Expert Consensus on Clinical Diagnosis and Treatment of Dry Eye（2013）. FS-LASIK was performed in the non-dry eye group,and 0. 1% sodium hyaluronate eye drops was topically administered for 1 month firstly and then the operation was carried out in the same way in the mild dry eye group. Slit lamp microscope, uncorrected visual acuity （UCVA） , best corrected visual acuity （BCVA）,spherical equivalent （SE） were examined, and the safety index and availability index were assessed. OQASTM Ⅱ analysis system was employed for the defection of Schirmer ] test （S I t） ,breakup time of tear film （BUT） ,modulation transfer function cut-off frequency （MTF cut off） and mean OSI before and after surgery. Results The safety index was 1.05±0. 11 and 1.03 ±0. 09, and the availability index was 1.02±0. 14 and 1.01 ±O. 12 in the non-dry eye group and mild dry eye group,respectively,showing significant differences between the two groups （t=0. 391,0. 147,both at P〉O. 05）. The BUT was evidently shortened 1 month and 3 mont
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2017年第12期1109-1114,共6页
Chinese Journal Of Experimental Ophthalmology
基金
南京市科技发展项目（201605028）
南京市医学科技发展项目（YKKl5091）
