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目的评估可降解型Visi Plug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 Keratomi Leusis,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Visi Plug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Visi Plug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。
Objective To evaluate the clinical effect and safety of degradable Visi plug lacrimal plug in the treatment of dry eye after laser in situ keratomileusis. Methods A total of 65 patients with LASIK (Laser Assisted In-situ Keratomi Leusis) preoperatively with mild to moderate dry eye before surgery from July 2009 to December 2013 130 eyes) were enrolled in the study. After the operation was completed, the eyes were punctured with a Visi Plug lacrimal plug. Patients were recorded before surgery, 1 week after surgery, 1 month and 3 months dryness, foreign body sensation, burning sensation, photophobia, visual fatigue and blurred vision 6 symptom scores, and at each time point on the basis of the patient tear Schirmer I test (SIt), break-up time (BUT) and fluorescein staining (FS). Results The scores of six symptom scores of dryness, foreign body sensation, burning sensation, photophobia, visual fatigue and blurred vision were decreased at all time points after operation, the differences were statistically significant (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). The SIt and BUT values increased at each time point after operation, and the FS scores decreased. The differences were statistically significant (F = 45.99,67.87,49.01, P = 0.000,0.000,0.000). All subjects did not have any infection during the observation time, spill plug or missing, such as the formation of local granuloma lacrimal plug implantation. Conclusion The application of degradable Visi Plug lacrimal plug can increase the amount of ocular surface tear, improve tear film stability and relieve dry eye symptoms after laser in situ keratomileusis safely and effectively.