可降解型VisiPlug泪道塞栓治疗准分子激光原位角膜磨镶术后干眼疗效观察

doi:10.6040/j.issn.1673-3770.0.2015.404

摘要/Abstract

摘要： 目的评估可降解型VisiPlug泪道塞栓治疗准分子激光原位角膜磨镶术后干眼的临床效果及安全性。方法将2009年7月至2013年12月就诊拟行准分子激光原位角膜磨镶术(Laser Assisted In-situ KeratomiLeusis,LASIK)且术前伴有轻到中度干眼的患者65例(130眼)纳入研究,手术完成后于当日行术眼下泪小点可降解型VisiPlug泪道塞栓植入。记录患者术前,术后1周、1个月及3个月干涩感、异物感、烧灼感、畏光感、视疲劳及视力模糊6项症状评分,并于各时间点对患者进行基础泪液分泌试验(Schirmer I test,SIt)、泪膜破裂时间(break-up time,BUT)以及角膜荧光素染色(fluorescein staining,FS)检查。结果术后各时间点干涩感、异物感、烧灼感、畏光感、视疲劳及视物模糊6项症状评分均有下降,差异有统计学意义(F=125.64、263.16、123.22、9.80、76.815、105.19,P=0.000、0.000、0.000、0.002、0.000、0.000)。术后各时间点SIt值及BUT值均有提高,FS评分均有下降,差异有统计学意义(F=45.99、67.87、49.01,P=0.000、0.000、0.000)。全部受试者在观察时间内均未发生感染、塞栓溢出或丢失、局部肉芽肿形成等泪道塞栓植入等情况。结论应用可降解型VisiPlug泪道塞栓可安全、有效地增加准分子激光原位角膜磨镶术后患者眼表泪液量,改善泪膜稳定性,缓解干眼症状。

关键词: 准分子激光原位角膜磨镶术, 泪道塞栓, 干眼

Abstract: Objective To evaluate the effect of the implantation of lacrimal plug for dry eyes after laser assisted in-situ keratomi leusis(LASIK). Methods Patients with mild to moderate dry eye were included in the study before LASIK. The implantation of VisiPlug was conducted immediately after the surgery. The scores of dryness, foreign body sensation, burning sensation, photophobia, visual fatigue and blurred vision were recorded on preoperative and postoperative 1 week, 1 month and 3 months. Schirmer I test(SIt), break-up time(BUT)and corneal fluorescein staining(FS)were also tested on each time points. Results There were 130 eyes of 65 patients included in the study, including 22 males and 43 females with the average age of 28.32±7.24(18-47)years. The scores of dryness, foreign body sensation, burning sensation, photophobia, visual fatigue and blurred vision were significantly decreased on each time points after the implantation of the lacrimal plug(F value: 125.64, 263.16, 123.22, 9.80, 76.815, 105.19; P value: 0.000, 0.000, 0.000, 0.002, 0.000, 0.000). Schirmer I test(SIt), break up time(BUT)and corneal fluorescein staining(FS)were also significantly improved on each time points(F value: 45.99, 67.87, 49.01; P value: 0.000, 0.000, 0.000). There was no infection, plug in the overflow, local granulation, and the effect of corneal flap healing. Conclusion Lacrimal plug could be effective and safe in the management of dry eyes after refractive surgery.

Key words: Dry eye, Lacrimal plug, Laser assisted in-situ keratomileusis

中图分类号:

R777

姜洋,李莹,王忠海,金玉梅,刘小伟. 可降解型VisiPlug泪道塞栓治疗准分子激光原位角膜磨镶术后干眼疗效观察[J]. 山东大学耳鼻喉眼学报, 2016, 30(2): 80-83.

JIANG Yang, LI Ying, WANG Zhonghai, JIN Yumei, LIU Xiaowei. Effect of the implantation of lacrimal plug for dry eyes after laser assisted in-situ keratomiLeusis.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(2): 80-83.

参考文献

[1] Solomon K D, Fernández de Castro L E, Sandoval H P, et al. Refractive surgery survey 2003[J]. J Cataract Refract Surg, 2004, 30(7):1556-1569.
[2] Jabbur N S, Sakatani K, OBrien T P. Survey of complications and recommendations for management in dissatisfied patients seeking a consultation after refractive surgery[J]. J Cataract Refract Surg, 2004, 30(9):1867-1874.
[3] Albietz J M, Lenton L M, McLennan S G. Chronic dry eye and regression after laser in situ keratomileusis for myopia[J]. J Cataract Refract Surg, 2004, 30(3):675-684.
[4] 杨斌, 王铮, 吴君舒, 等. 准分子激光原位角膜磨镶术后泪膜的早期改变[J].中华眼科杂志, 2002,2(1):76-84. YANG Bin, WANG Zheng, WU Junshu, et al. The early changes of tear film after laser in situ keratomileusis[J]. Chin J Ophthalmol, 2002, 2(1):76-84.
[5] Kim W S, Kim J S.Change in corneal sensitivity following laser in situ keratomileusis[J]. J Cataract Refract Surg, 1999, 25(3):368-373.
[6] Linna T U, Vesaluoma M H, Pérez-Santonja J J, et al. Effect of myopic LASIK on corneal sensitivity and morphology of subbasal nerves[J]. Invest Ophthalmol Vis Sci, 2000, 41(2):393-397.
[7] Albietz J, Lenton L, McLennan S. The effect of tear film and ocular surface management on myopic LASIK outcomes[J]. Adv Exp Med Biol, 2002, 506(Pt A):711-717.
[8] 晏晓明.重视对LASIK围手术期干眼的认识和处理[J]. 眼科, 2006,3(2):154-157. YAN Xiaoming. Stress on recognition and perioperative management of dry eye after LASIK[J]. Ophthalmol Chin, 2006, 3(2):154-157.
[9] Albietz J M, Lenton L M. Management of the ocular surface and tear film before, during, and after laser in situ keratomileusis[J]. J Refract Surg, 2004, 20(1):62-71.
[10] Alfawaz A M, Algehedan S, Jastaneiah S S, et al. Efficacy of punctal occlusion in management of dry eyes after laser in situ keratomileusis for myopia[J]. Curr Eye Res, 2014, 39(3):257-262.
[11] Yung Y H, Toda I, Sakai C, et al. Punctal plugs for treatment of post-LASIK dry eye[J]. Jpn J Ophthalmol, 2012, 56(3):208-213.
[12] Huang B, Mirza M A, Qazi M A, et al. The effect of punctal occlusion on wavefront aberrations in dry eye patients after laser in situ keratomileusis[J]. Am J Ophthalmol, 2004,137(1):52-61.
[13] 刘睿, 周行涛, 于志强, 等. 泪道栓治疗准分子激光角膜屈光术后干眼疗效评价[J]. 中国眼耳鼻喉科杂志, 2011, 11(1):22-28. LIU Rui, ZHOU Xingtao, YU Zhiqiang, et al. Therapeutic effect of lacrimal plug for dry eyes after refractive surgery[J]. Chin J Ophthalmol Otorhinolaryngol, 2011, 11(1):22-28.
[14] 陶爱平, 接英. 可降解泪小管栓塞治疗准分子激光原位角膜磨镶术后患者干眼症疗效观察[J]. 安徽医学, 2012, 33(11):1444-1447. TAO Aiping, JIE Ying. Effects of degradable lacrimal plug on treating dry eye after Lasik surgery[J]. Anhui Med, 2012, 33(11):1444-1447.
[15] Kojima T, Matsumoto Y, Ibrahim O M, et al. Evaluation of a thermosensitive atelocollagen punctal plugtreatment for dry eye disease[J]. Am J Ophthalmol, 2014, 157(2):311-317.e1.
[16] Paparizos S C, Edward D P, Osmanovic S. Plug surface defects as a late complication of silicone punctal plugs[J]. Cornea, 2013, 32(9):1224-1226.
[17] Kaido M, Ishida R, Dogru M, et al. Visual function changes after punctal occlusion with the treatment of short BUT type of dry eye[J]. Cornea, 2012, 31(9):1009-1013.

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