Dry eye associated with laser in situ keratomileusis: Mechanical microkeratome versus femtosecond laser.
Dry eye associated with laser in situ keratomileusis: Mechanical microkeratome versus femtosecond laser.
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DOI：
10.1016/j.jcrs.2009.05.032
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发表时间：
2009-10
影响因子：
2.8
通讯作者：
Wilson, Steven E.
中科院分区：
文献类型：
--
作者：
Salomao, Marcella Q.;Ambrosio, Renato, Jr.;Wilson, Steven E.
目的：比较准分子激光原位角膜磨镶术(LASIK)相关干眼的发生率和使用飞秒激光或机械微型角膜刀制作角膜瓣后是否需要环孢素A治疗。科尔眼科研究所，美国俄亥俄州克利夫兰。随机选择使用IntraLase飞秒激光(30或60 kHz)或Hansatome微型角膜刀制作角膜瓣。术前无患者出现干眼的体征、症状或治疗。术中超声测厚确定皮瓣厚度。评估手术前和术后1个月的角膜裂隙灯评估和术后干眼治疗的必要性。用飞秒激光制作角膜瓣113只眼，用微型角膜刀制作角膜瓣70只眼。平均中央角膜瓣厚度飞秒组(111μm±14[SD])与微角膜刀组(131±25μm)比较，差异有统计学意义(P&t；.001)。LASIK相关干眼的发生率在微角膜刀组(46%)显著高于飞秒组(8%)(P<；.0001)，术后需要环孢素A治疗(分别为24%和7%)(P<；.01)。在微角膜刀组中，厚角膜瓣与LASIK诱导的干眼症的发生率没有相关性。具有飞秒瓣的眼睛LASIK相关干眼的发生率较低，并且需要较少的疾病治疗。除了角膜神经切断的神经营养作用外，其他因素可能也很重要，因为没有发现角膜瓣厚度(或切削深度)与LASIK诱导的干眼发生率之间的相关性。
To compare the incidence of laser in situ keratomileusis (LASIK)–associated dry eye and the need for postoperative cyclosporine A treatment after flap creation with a femtosecond laser or a mechanical microkeratome. Cole Eye Institute, Cleveland, Ohio, USA. Eyes were randomized to flap creation with an IntraLase femtosecond laser (30 or 60 kHz) or a Hansatome microkeratome. No patient had signs, symptoms, or treatment of dry eye preoperatively. Flap thickness was determined by intraoperative ultrasonic pachymetry. Slitlamp assessments of the cornea and need for postoperative dry-eye treatment were evaluated preoperatively and 1 month postoperatively. The flap was created with the femtosecond laser in 113 eyes and with the microkeratome in 70 eyes. The difference in mean central flap thickness between the femtosecond group (111 μm ± 14 [SD]) and the microkeratome group (131 ± 25 μm) was statistically significant (P<.001). The incidence of LASIK-associated dry eye was statistically significantly higher in the microkeratome group (46%) than in the femtosecond group (8%) (P<.0001), as was the need for postoperative cyclosporine A treatment (24% and 7%, respectively) (P<.01). In the microkeratome group, there was no correlation between thick flaps and a higher incidence of LASIK-induced dry eye. Eyes with femtosecond flaps had a lower incidence of LASIK-associated dry eye and required less treatment for the disorder. In addition to neurotrophic effects from corneal nerve cutting, other factors may be important because no correlation was found between flap thickness (or ablation depth) and the incidence of LASIK-induced dry eye.
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影响因子：
2.8
作者：
Mian, Shahzad I.;Shtein, Roni M.;Musch, David C.
通讯作者：
Musch, David C.
影响因子：
13.7
作者：
Wilson, SE
通讯作者：
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作者：
Battat, L;Macri, A;Pflugfelder, SC
通讯作者：
Pflugfelder, SC
影响因子：
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作者：
Vroman, DT;Sandoval, HP;Solomon, KD
通讯作者：
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影响因子：
4.2
作者：
Wilson, SE;Ambrosio, R
通讯作者：
Ambrosio, R