Comparison of dry eye and corneal sensitivity between small incision lenticule extraction and femtosecond LASIK for myopia.
Comparison of dry eye and corneal sensitivity between small incision lenticule extraction and femtosecond LASIK for myopia.
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小切口角膜基质透镜摘除术与飞秒LASIK治疗近视的干眼和角膜敏感性比较。
DOI：
10.1371/journal.pone.0077797
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zhou X
中科院分区：
文献类型：
--
作者：
Li M;Zhao J;Shen Y;Li T;He L;Xu H;Yu Y;Zhou X
探讨小切口角膜基质透镜摘除术（SMILE）和飞秒激光近视手术（femto-LASIK）术后干眼症状和临床体征以及角膜敏感性的变化。前瞻性、非随机比较研究。该研究共纳入 71 名患者的 71 只眼睛； SMILE 组包括 38 名患者的 38 只眼睛，femto-LASIK 组包括 33 名患者的 33 只眼睛。术前及术后1周、1个月、3个月、6个月评估眼表疾病指数（OSDI）、泪膜破裂时间（TBUT）、无麻醉Schirmer试验（S1T）、角膜荧光素染色和中央角膜感觉。两组OSDI评分均立即升高，术后1个月恢复至术前水平。相对于术前评分，两组患者术后 TBUT 值均有所降低。与 femto-LASIK 组相比，SMILE 组患者发生角膜染色的可能性较小（[比值比] OR = 0.50，95% [置信区间] CI 0.28 至 0.93，P = 0.03）。两组术后所有时间点的中央角膜敏感性均下降。然而，SMILE组在术后所有时间点的中央角膜感觉评分均高于femto-LASIK组（均P<0.05）。 SMILE 手术导致干眼症状短期增加、泪膜不稳定和角膜敏感性丧失。此外，SMILE 手术优于飞秒激光手术，术后角膜染色的风险较低，角膜感觉下降较少。
To investigate the changes in dry eye symptoms and clinical signs and corneal sensitivity after small incision lenticule extraction (SMILE) and femtosecond LASIK (femto-LASIK). Prospective, non-randomized comparative study. The study included a total of 71 eyes of 71 patients; the SMILE group comprised 38 eyes of 38 patients, and the femto-LASIK group comprised 33 eyes of 33 patients. Ocular Surface Disease Index (OSDI), Tear film breakup time (TBUT), the Schirmer test without anesthesia (S1T), corneal fluorescein staining, and central corneal sensation were evaluated before surgery and at 1 week, 1 month, 3 months, and 6 months after surgery. OSDI scores in both groups were increased immediately and returned to preoperative level at 1 month after surgeries. The TBUT values in both groups were reduced after surgeries relative to their preoperative scores. Patients in SMILE group were less likely to have corneal staining compared with those in the femto-LASIK group ([odds ratio] OR = 0.50, 95% [confidence interval] CI 0.28 to 0.93, P = 0.03). Central corneal sensitivity was decreased at all postoperative time points in both groups. However, the central corneal sensation scores in the SMILE group were greater than that in the femto-LASIK group at all of the postoperative time points (all P<0.05). SMILE surgeries resulted in a short-term increase in dry eye symptoms, tear film instability, and loss of corneal sensitivity. Furthermore, SMILE surgeries have superiority over femto-LASIK in lower risk of postoperative corneal staining and less reduction of corneal sensation.
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