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LENSTAR LS900与眼前节分析系统SIRIUS对前房深度测量的对比分析

目的　比较LENSTAR LS900与眼前节分析系统SIRIUS测量准分子激光手术患者术前前房深度（ACD）的一致性。 方法　选取2011年11月20日－12月10日对29例（58只眼）进行屈光手术术前检查的患者，其中男12例，女17例，年龄18～40岁，平均21.5岁，分别采用LENSTAR LS900和眼前节分析系统SIRIUS测量ACD。采用配对t检验、直线回归分析比较检查结果的差异和两种设备测量结果的相关性；运用Bland-Altman法对两种方法进行一致性分析评价。 结果　LENSTAR LS900测量的ACD平均值为（3.78 ± 0.26）mm，眼前节分析系统SIRIUS测量的ACD平均值为（3.84 ± 0.23）mm，两种仪器测量结果差异无统计学意义（P ＞0.05）；相关系数分析显示两者有较高的相关性（r=0.960，P＜0.05）；两种仪器测量ACD的Bland-Altman一致性分析，95%一致性界限为（0.089 mm，0.211 mm），在一致性界限范围内。 结论　LENSTAR LS900与眼前节分析系统SIRIUS眼前节分析系统具有较高的一致性，可以互相替代，都可作为临床ACD测量的工具。

近视角膜屈光手术后睑板腺功能障碍一例

Effects of small incision lamellar extraction, femtosecond-laser in situ keratomileusis and sub-Bowman keratomileusis on postoperative dry eye and corneal sensation

Objection To compare the effects of three mainstream surgical methods on the ocular surface and investigate the optimal corneal myopia correction surgery. Methods We selected 118 patients (236 eyes) undergoing small incision lamellar extraction (SMILE) (40 patients, 80 eyes), femtosecond-laser in situ keratomileusis (FS-LASIK) (36 patients, 72 eyes) or sub-Bowman keratomileusis (SBK) (42 patients, 84 eyes) surgery for corneal myopia correction from March 2015 to January 2016. Before surgery, one week and one month after surgery, tear film rupture time, tear river height and eye red index were measured using ocular surface analyzer. The Schimer Ⅰ test was used to detect tear secretion. Corneal sensory gauge was used to measure corneal sensation. Analysis of variance was used to analyze the measurements of the three surgical methods at various time points. Results The tear film rupture time of the three groups decreased after one week (P<0.05), but the time in the SMILE group [(9.643±4.751) seconds] was longer than those in the other two groups [FS-LASIK (8.172±4.300) seconds, SBK (7.612±3.691) seconds,P<0.05]. The time in the SMILE group at one month after surgery was not different from that before surgery (P>0.05). At one month after surgery, the rupture times of the other two groups were still shortened (P<0.05). The tear river heights in the three groups were decreased at one week and one month after surgery (P<0.05), except FS-LASIK group (P>0.05). In the SBK group, at one week after surgery, the decrease of the height was the most obvious (P<0.05). There was no difference in eye red index among the three groups at the time of observation (P>0.05). Corneal sensation decreased in the three groups at one week and one month after surgery. In the SBK group, that was the most obvious decline (P<0.05). In the three groups, the tear secretion did not change at each observation time point (P>0.05). Conclusion In the three surgical methods, SMILE has the minimal impact on the ocular surface, followed by FS-LASIK, and SBK has the greatest impact.