山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 60-63.doi: 10.6040/j.issn.1673-3770.0.2015.205

• 论著 • 上一篇    下一篇

表层角膜屈光手术后疼痛及角膜刺激症状的观察

崔长霞1, 陶祥臣2, 朱伟3   

  1. 1. 山东大学附属济南市中心医院健康体检中心, 山东 济南 250013;
    2. 山东大学附属省立医院眼科, 山东 济南 250021;
    3. 山东大学附属济南市中心医院眼科, 山东 济南 250013
  • 收稿日期:2015-05-27 出版日期:2015-12-16 发布日期:2015-12-16
  • 通讯作者: 朱伟. E-mail:zxyzhuwei@163.com E-mail:zxyzhuwei@163.com
  • 作者简介:崔长霞. E-mail:mgyeyes@aliyun.com

Postoperative pain and corneal irritation after surface corneal refractive surgery

CUI Changxia1, TAO Xiangchen2, ZHU Wei3   

  1. 1. Physical Examination Center, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China;
    2. Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    3. Department of Ophthalmology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China
  • Received:2015-05-27 Online:2015-12-16 Published:2015-12-16

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摘要： 目的 探讨表层角膜屈光手术不同手术方式术后疼痛以及角膜刺激症状的差异.方法 选取行表层角膜屈光手术的近视患者600例(1 200眼),根据不同手术方式分为准分子激光屈光性角膜切削术(PRK)组、乙醇法准分子激光上皮瓣下角膜磨镶术(LASEK)组和微型上皮刀法准分子激光上皮瓣下角膜磨镶术(Epi-LASIK)组,比较三组之间的疼痛指数以及角膜刺激症状.结果 术后第1天,PRK组与LASEK组疼痛指数及角膜刺激症状差异无统计学意义,Epi-LASIK组与其余两组差异有统计学意义.术后第2天、第3天,PRK组与其余两组相比差异有统计学意义,LASEK组与Epi-LASIK组相比差异无统计学意义.术后第5天三组之间疼痛指数以及角膜刺激症状差异均无统计学意义.结论 表层角膜屈光手术后疼痛是导致患者术后不适的主要因素.手术方式不同,患者术后的疼痛指数以及角膜刺激症状存在差异.

关键词: 乙醇法准分子激光上皮瓣下角膜磨镶术, 微型上皮刀法准分子激光上皮瓣下角膜磨镶术, 准分子激光屈光性角膜切削术, 疼痛

Abstract: Objective To investigate the postoperative pain and corneal irritation after superficial corneal refractive surgery by different surgical procedures. Methods A total of 600 cases (1 200 eyes) of surface corneal refractive surgery were divided into 3 groups according to different operation methods as photorefractive keratectomy group (PRK group), laser epithelial keratomileusis group (LASEK group) and epipolis laser in-situ keratomileusis group (Epi-LASIK group). The pain index and corneal irritation among the three groups were compared. Results On day 1 after surgery, there was no statistical difference in the pain index and corneal irritation between PRK group and LASEK group, but there was statistical difference between Epi-LASIK group and the other two groups. On day 2 and 3 postoperatively, there was statistical difference between the PRK group and the other two groups, but there was no statistical difference between LASEK group and Epi-LASIK group. One day 5 after surgery, there was no difference among the three groups. Conclusion The pain after surface corneal refractive surgery is the major factor of postoperative discomfort for patients. Postoperative pain index and corneal irritation are different for different operation methods.

Key words: Pain, Photorefractive keratectomy, Laser epithelial keratomileusis, Epipolis laser in-situ keratomileusis

中图分类号: 

  • R778.1
[1] Rudolf A, Jaroslav R. Laser-assisted subepithelial keratectomy and photorefractive keratectomy for the correction of hyperopia: Results of a 2-year follow-up [J]. J Cataract Refract Surg, 2003, 29(11):2105-2114.
[2] 王勤美. 屈光手术学[M]. 北京: 人民卫生出版社, 2011:81-122.
[3] Ghoreishi M, Attarzadeh H. Alcohol-assisted versus mechanical epithelium removal in photorefractive keratectomy [J]. J Ophthalmic Vis Res, 2010, 5(4):223-227.
[4] Ghadhfan F, AL-Rajhi A, Wagoner M D. Laser in situ keratomileusis versus surface ablation: visual outcomes and complications[J]. J Cataract Refract Surg, 2007, 33(12):2041-2048.
[5] Angunawela R I, Winkler von Mohrenfels C, Kumar A, et al. Live or let die: epithelial flap vitality and keratocyte proliferation following LASEK and epi-LASIK in hurnan donor and porcine eyes[J]. J Refract Surg, 2011, 27(2):111-118.
[6] Kim J H, Lim T, Lee H G, et al. Bilateral comparison of conventional epithelial laser in situ keratomileusis and lamellar epithelial debridement for moderate to high myopia[J]. Cornea, 2010, 29(8):853-857.
[7] O'Doherty M, Kirwan C, O'Keeffe M, et al. Postoperative pain following Epi-LASIK, LASEK, and PRK for myopia [J]. J Refract Surg, 2007, 23(2):133-138.
[8] 刘维锋, 杜之渝, 赵武校, 等. 兔Epi-LASIK术后早期角膜创伤愈合反应的研究[J]. 眼科研究, 2008, 26(2):92-95. LIU Weifeng, DU Zhiyu, ZHAO Wuxiao, et al. Early corneal wound healing response after epipolis laser in-situ keratomileusis in rabbits [J]. Chin Ophthal Res, 2008, 26(2):92-95.
[9] 钱志刚, 柯敏, 黄刚, 等. PRK与LASEK治疗近视比较的Meta分析[J]. 中华眼视光与视觉科学杂志, 2012, 14(9): 530-535. QIAN Zhigang, KE Min, HUANG Gang, et al. Photorefractive keratectomy versus laser subepithelial keratectomy (LASEK) for the correction of myopia: a meta-analysis [J]. Chin J Optometry Ophthalmol, 2012, 14(9):530-535.
[10] Magone M T, Engle A T, Easter T H, et al. Flap-off epi-LASIK versus automated epithelial brush in PRK: a prospective comparison study of pain and reepithelialization times[J]. J Refract Surg, 2012, 28(10):682-688.
[11] Doherty M, Kirwan, Keeffe M. Postoperative pain following Epi-LASIK, LASEK, and PRK for myopia[J]. J Refract Surg, 2007, 23(2):133-138.
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