中文摘要：

目的：观察Keratograph眼表综合分析仪检查不同年龄组患者飞秒激光制瓣准分子激光原位角膜磨镶术（laser in situ keratomileusis,LASIK）术后泪膜的变化。方法：选择性收集2014-07/2015-06在中山市人民医院行飞秒激光制瓣LASIK的患者75例150眼,要求30岁以下、30~40岁、40岁以上患者各选取25例50眼。检查术前,并随访术后1wk,1、2、3mo时患者的Keratograph眼表综合分析仪检查的泪膜破裂时间（tear break-up time,BUT）、泪河高度（tear meniscus height,TMH）,并应用Mc Monnies干眼病史问卷调查表（Mc Monnies Questionnaire,MQ）评估干眼症状得分。结果：三组患者术前干眼症状评分差异无统计学意义（P〉0.05）,术后各时间点差异均有统计学意义（P〈0.05）,均为〈30岁组最低,40岁以上组最高。术后1wk,三组干眼症状评分均较术前明显上升,随后均逐渐下降。其中,30岁以下、30~40岁组在术后2mo评分下降至术前水平,40岁以上组在术后3mo下降到术前水平。三组患者术前和术后各时点BUT和TMH差异均有统计学意义（P〈0.05）,两指标均为〈30岁组最高,40岁以上组最低。术后1wk,三组患者两指标均较术前明显下降,随后均逐渐上升。其中,30岁以下、30~40岁组在术后3mo BUT回升至术前水平,而40岁以上组未回升到术前水平;30岁以下的TMH在术后2mo即回升到与基线没有统计学差异,30~40岁组、40岁以上组的TMH在术后3mo回升到与基线没有统计学差异。结论：飞秒激光制瓣LASIK术可影响干眼症状和泪膜的稳定性,影响程度随术后时间逐渐减弱,年龄越小的患者更快恢复至术前水平。

英文摘要：

AIM：To explore the changes of tear film detected by Keratograph in the patients after laser in situ keratomileusis（LASIK） with corneal flap created by femtosecond laser.·METHODS：Totally 75 myopic patients（150 eyes） were enrolled who underwent femtosecond laser LASIK from July 2014 to June 2015,including patients30,30 ~40,over 40 years old and 25 cases（50 eyes） in each group.Tear break-up time（BUT）,tear meniscus height（TMH）,McMonnies Dry Eye Disease Questionnaire（McMonnies Questionnaire,MQ） were checked preoperatively and postoperatively at 1wk,1,2 and 3mo.·RESULTS：Before surgeries,the dry eye symptoms score of three groups had no significant difference（P0.05）.After surgeries,there were significant difference at each follow- up time among the three groups on symptoms score（P0.05）,with 30 years old group the lowest and over 40 years old group the highest.Dry eye symptom scores rise obviously at postoperatively 1wk and then declined gradually.The scores of 30,30~40 years old group fell to the preoperative levels at 2mo,while that happened in over 40 group at 3mo after surgeries.BUT and TMH of three groups had significant differences at each follow-up point（P0.05）,with 30 years old group the highest,over 40 years old group the lowest.A 1wk after surgeries,the indexes declined obviously and then rise.BUT of 30,30~40 years old group recovered to preoperative levels at 3mo,with over 40 years old group not recovered.TMH of 30 years group recovered to preoperative levels at 2mo,with 30~40 and over 40 years old group recovered at 3mo.·CONCLUSION：LASIK can affect the dry eye symptoms and the stability of tear film,which decreased by postoperative time.And the index recovered to preoperative levels earlier in younger patients.