目的:评价甲钴胺超声雾化对LASIK术后角膜神经修复的影响。方法:我院行LASIK术式患者72例,屈光度-1.50～-4.50D,随机分为A,B,C三组,每组24例,所有患者行LASIK手术后进行治疗,A组空白对照组:手术后不进行抗干眼症处理。B组人工泪液点眼组:手术后点用人工泪液。C组超声雾化甲钴胺组:手术后超声雾化甲钴胺治疗。观察三组患者术前、术后1wk;1,3mo时测泪膜破裂时间(tear filmbreak-up time,BUT)、泪液分泌量和角膜前基质层神经纤维密度的变化。结果:与A组相比,B组术后1mo开始BUT明显增加,C组术后1wk;1,3mo时BUT明显增加,且差异有统计学意义(P<0.05)。与A组相比,B和C组不同时期泪液分泌量明显增加(P<0.05);与B组相比,C组术后1,3mo泪液分泌量明显增加(P<0.05)。与A,B两组相比,LASIK术后C组角膜中央区新生神经纤维面积均明显增加(P<0.05)。结论:甲钴胺超声雾化可以减少LASIK术后干眼症的发生,同时修复受损的角膜感觉神经。

AIM:To evaluate the impact of ultrasonic atomization of methylcobalamin on corneal nerve recovery after LASIK.METHODS:Seventy-two patients in our hospital underwent LASIK,refraction degree -1.50-- 4.50D were randomly divided into A,B,C three groups,each group 24 cases.After LASIK surgery,all patients were treated as following:group A (control group) without anti-dry eye treatment;group B using artificial tears after surgery;group C(ultrasonic atomization methylcobalamin group) using ultrasonic spray methylcobalamin treatment after surgery.We observed tear film break up time (BUT),tear secretion amount and corneal anterior stromal layer of nerve fiber density in three groups preoperative and postoperative 1 week,1 month and 3 months.RESULTS:Compared with the group A,BUT in group B after 1 month significantly increased,and it significantly increased in group C postoperative 1 week,1 month and 3 months(P<0.05).Compared with group A,tear secretion amount in group B and C during different periods increased significantly(P<0.05).Compared with group B,tear secretion amount in group C after 1 month and 3 months increased significantly(P<0.05).Nerve fibers in the central district area of newborn increased significantly in group C compared with group A and B after LASIK corneal surgery(P<0.05).CONCLUSION:Ultrasonic atomization of methylcobalamin on patients after LASIK corneal surgery can reduce the occurrence of dry eye and repair the damaged corneal sensory nerves.

R779.63

中国湖南省衡阳市科技支撑计划资助项目(No.2008KS015)~~