角膜屈光术后干眼发病机制及治疗的研究
Study on the Pathogenesis and Treatment of Dry Eye after Corneal Refractive Surgery
DOI: 10.12677/HJO.2022.113029, PDF,   
作者: 郑思雨：甘肃中医药大学第一临床医学院(甘肃省人民医院)，甘肃 兰州；兰州华厦眼科医院，甘肃中医药大学附属眼科中心，甘肃 兰州；燕振国：兰州华厦眼科医院，甘肃中医药大学附属眼科中心，甘肃 兰州
关键词: 屈光外科手术；飞秒激光；准分子激光原位角膜磨镶术；干眼；发病机制；治疗；Refractive Surgery； Femtosecond Laser； Laser in Situ Keratomileusis； Dry Eye； Pathogenesis； Treatment
摘要: 我国是一个近视大国，许多近视患者想摆脱眼镜的困扰选择了屈光手术，角膜屈光术后干眼通常是暂时的，但会造成不规则散光，诱发高阶像差，造成患者术后视觉质量和手术满意度下降。本文就角膜屈光术后干眼的发病机制、治疗研究进展进行综述，以期屈光医师对有干眼症风险的患者采取预防措施，对角膜屈光术后干眼患者治疗提供依据。
Abstract: My country is a big country of myopia. Many myopia patients choose refractive surgery to get rid of glasses. Dry eye after corneal refractive surgery is usually temporary, but it can cause irregular astigmatism, induce higher order aberrations, and cause decreased postoperative visual quality and surgical satisfaction in patients. This article reviews the research progress on the pathogenesis and treatment of dry eye after corneal refractive surgery, in order to provide a basis for clinicians to take preventive measures for patients at risk of dry eye after corneal refractive surgery.
文章引用：郑思雨, 燕振国. 角膜屈光术后干眼发病机制及治疗的研究[J]. 眼科学, 2022, 11(3): 207-214. https://doi.org/10.12677/HJO.2022.113029

参考文献

[1] Wong, A.H.Y., Cheung, R.K.Y., Kua, W.N., Shih, K.C., Chan, T.C.Y. and Wan, K.H. (2019) Dry Eyes after SMILE. Asia-Pacific Journal of Ophthalmology, 8, 397-405.
[Google Scholar] [CrossRef] 
[2] Shehadeh-Mashor, R., Mimouni, M., Shapira, Y., Sela, T., Munzer, G. and Kaiserman, I. (2019) Risk Factors for Dry Eye after Refractive Surgery. Cornea, 38, 1495-1499.
[Google Scholar] [CrossRef] 
[3] Cetinkaya, S., Gulmez, M., Mestan, E., Ucar, F. and Ali, N. (2019) Influence of Incision Size on Dry Eye Symptoms in the Small Incision Lenticule Extraction Procedure. Cornea, 38, 18-23.
[Google Scholar] [CrossRef] 
[4] Kobashi, H., Kamiya, K. and Shimizu, K. (2017) Dry Eye after Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK: Meta-Analysis. Cornea, 36, 85-91.
[Google Scholar] [CrossRef] 
[5] 赵展琳. 干眼与神经调节异常相关研究进展[J]. 中华实验眼科杂志, 2020, 38(3): 233-237.
[6] 中华医学会眼科学分会眼视光学组, 中国医师协会眼科医师分会眼视光学组, 中国医师协会眼科医师分会屈光手术学组. 中国角膜屈光手术围手术期干眼诊疗专家共识(2021年) [J]. 中华眼科杂志, 2021, 57(9): 644-650.
[Google Scholar] [CrossRef] [PubMed]
[7] Sanchez-Avila, R.M., Merayo-Lloves, J., Fernandez, M.L., Rodriguez-Gutierrez, L.A., Jurado, N., Muruzabal, F., et al. (2018) Plasma Rich in Growth Factors for the Treatment of Dry Eye after LASIK Surgery. Ophthalmic Research, 60, 80-86.
[Google Scholar] [CrossRef] [PubMed]
[8] 杨琨, 薛超, 金颖, 耿维莉. 对比玻璃酸钠与rb-bFGF治疗LASEK术后角膜上皮修复及敏感性恢复的作用[J]. 基础医学与临床, 2019, 39(3): 396-399.
[9] Zhou, X., Shen, Y., Shang, J. and Zhou, X. (2021) Effects of Warm Compress on tear Film, Blink Pattern and Meibomian Gland Function in Dry Eyes after Corneal Refractive Surgery. BMC Ophthalmology, 21, Article No. 330.
[Google Scholar] [CrossRef] [PubMed]
[10] Fuentes, P.G., Soler, T.J. and Burillo, S. (2020) Intense Pulsed Light: Results in Chronic Dry Eye Syndrome after LASIK. Archivos de la Sociedad Española de Oftalmología, 95, 226-230.
[Google Scholar] [CrossRef] 
[11] Sharma, B., Soni, D., Saxena, H., Stevenson, L.J., Karkhur, S., Takkar, B., et al. (2020) Impact of Corneal Refractive Surgery on the Precorneal Tear Film. Indian Journal of Ophthalmology, 68, 2804-2812.
[Google Scholar] [CrossRef] 
[12] Eydelman, M., Hilmantel, G., Tarver, M.E., Hofmeister, E.M., May, J., Hammel, K., et al. (2017) Symptoms and Satisfaction of Patients in the Patient-Reported Outcomes with Laser in Situ Keratomileusis (PROWL) Studies. JAMA Ophthalmology, 135, 13-22.
[Google Scholar] [CrossRef] [PubMed]
[13] Bandeira, F., Yam, G.H., Liu, Y.C., Devarajan, K. and Mehta, J.S. (2019) Three-Dimensional Neurite Characterization of Small Incision Lenticule Extraction Derived Lenticules. Investigative Ophthalmology & Visual Science, 60, 4408-4415.
[Google Scholar] [CrossRef] [PubMed]
[14] Bozkurt, A., Lassner, F., O’Dey, D., Deumens, R., Böcker, A., Schwendt, T., et al. (2012) The Role of Microstructured and Interconnected Pore Channels in a Collagen-Based Nerve Guide on Axonal Regeneration in Peripheral Nerves. Biomaterials, 33, 1363-1375.
[Google Scholar] [CrossRef] [PubMed]
[15] Carr, M.J. and Johnston, A.P. (2017) Schwann Cells as Drivers of Tissue Repair and Regeneration. Current Opinion in Neurobiology, 47, 52-57.
[Google Scholar] [CrossRef] [PubMed]
[16] Al-Aqaba, M.A., Dhillon, V.K., Mohammed, I., Said, D.G. and Dua, H.S. (2019) Corneal Nerves in Health and Disease. Progress in Retinal and Eye Research, 73, Article ID: 100762.
[Google Scholar] [CrossRef] [PubMed]
[17] Demirok, A., Ozgurhan, E.B., Agca, A., Kara, N., Bozkurt, E., Cankaya, K.I., et al. (2013) Corneal Sensation after Corneal Refractive Surgery with Small Incision Lenticule Extraction. Optometry and Vision Science, 90, 1040-1047.
[Google Scholar] [CrossRef] 
[18] Liu, Y.C., Jung, A.S.J., Chin, J.Y., Yang, L.W.Y. and Mehta, J.S. (2020) Cross-Sectional Study on Corneal Denervation in Contralateral Eyes Following SMILE versus LASIK. Journal of Refractive Surgery, 36, 653-660.
[Google Scholar] [CrossRef] 
[19] Gao, S., Li, S., Liu, L., Wang, Y., Ding, H., Li, L., et al. (2014) Early Changes in Ocular Surface and Tear Inflammatory Mediators after Small-Incision Lenticule Extraction and Femtosecond Laser-Assisted Laser in Situ Keratomileusis. PLOS ONE, 9, Article ID: e107370.
[Google Scholar] [CrossRef] [PubMed]
[20] Liu, Y.C., Yam, G.H., Lin, M.T., Teo, E., Koh, S.K., Deng, L., et al. (2021) Comparison of Tear Proteomic and Neuromediator Profiles Changes between Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser-Assisted in-Situ Keratomileusis (LASIK). Journal of Advanced Research, 29, 67-81.
[Google Scholar] [CrossRef] [PubMed]
[21] Blanco-Mezquita, T., Martinez-Garcia, C., Proença, R., Zieske, J.D., Bonini, S., Lambiase, A., et al. (2013) Nerve Growth Factor Promotes Corneal Epithelial Migration by Enhancing Expression of Matrix Metalloprotease-9. Investigative Ophthalmology & Visual Science, 54, 3880-3890.
[Google Scholar] [CrossRef] [PubMed]
[22] González-García, M.J., Murillo, G.M., Pinto-Fraga, J., García, N., Fernández, I., Maldonado, M.J., et al. (2020) Clinical and Tear Cytokine Profiles after Advanced Surface Ablation Refractive Surgery: A Six-Month Follow-Up. Experimental Eye Research, 193, Article ID: 107976.
[Google Scholar] [CrossRef] [PubMed]
[23] Toda, I. (2018) Dry Eye after LASIK. Investigative Ophthalmology & Visual Science, 59, DES109-DES115.
[Google Scholar] [CrossRef] [PubMed]
[24] Zhang, H. and Wang, Y. (2018) Dry Eye Evaluation and Correlation Analysis between Tear Film Stability and Corneal Surface Regularity after Small Incision Lenticule Extraction. International Ophthalmology, 38, 2283-2288.
[Google Scholar] [CrossRef] [PubMed]
[25] 康杨, 胡琦, 李雪, 吴琼, 杨帆, 周文艳. 利用眼反应分析仪评估FS-LASIK和LASEK术后角膜生物力学稳定性[J]. 国际眼科杂志, 2018, 18(11): 2116-2118.
[26] 马娇楠, 王雁, 张琳, 张佳媚. 小切口角膜基质透镜取出术中负压脱失的临床研究[J]. 中华眼科杂志, 2018, 54(12): 890-896.
[27] Moshirfar, M., Bhavsar, U.M., Durnford, K.M., McCabe, S.E., Ronquillo, Y.C., Lewis, A.L., et al. (2021) Neuropathic Corneal Pain Following LASIK Surgery: A Retrospective Case Series. Ophthalmology and Therapy, 10, 677-689.
[Google Scholar] [CrossRef] [PubMed]
[28] 郑晓红, 赵少贞. 质量分数0.1％和0.3％玻璃酸钠滴眼液对FS-LASIK术后干眼泪膜稳定性及视觉质量的影响[J]. 中华实验眼科杂志, 2018, 36(5): 373-379.
[29] Miháltz, K., Faschinger, E.M. and Vécsei-Marlovits, P.V. (2018) Effects of Lipid- versus Sodium Hyaluronate-Containing Eye Drops on Optical Quality and Ocular Surface Parameters as a Function of the Meibomian Gland Dropout Rate. Cornea, 37, 886-892.
[Google Scholar] [CrossRef] 
[30] 权菊玲, 张敏, 李丹, 杨小娟, 姚辉. 0.3％玻璃酸钠对屈光不正患者飞秒激光联合LASIK术后视觉质量及泪膜稳定性的影响[J]. 海南医学, 2020, 31(1): 66-68.
[31] 聂惠玲, 姚进. 术前应用人工泪液降低近视激光术治疗后干眼的效果观察[J]. 现代科学仪器, 2021, 38(5): 237-241.
[32] Igarashi, A., Kamiya, K., Kobashi, H. and Shimizu, K. (2015) Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye after Corneal Refractive Surgery. Cornea, 34, 895-900.
[Google Scholar] [CrossRef] 
[33] Mori, Y., Nejima, R., Masuda, A., Maruyama, Y., Minami, K., Miyata, K., et al. (2014) Effect of Diquafosol Tetrasodium Eye Drop for Persistent Dry Eye after Laser in Situ Keratomileusis. Cornea, 33, 659-662.
[Google Scholar] [CrossRef] 
[34] Koh, S. (2015) Clinical Utility of 3% Diquafosol Ophthalmic Solution in the Treatment of Dry Eyes. Clinical Ophthalmology, 9, 865-872.
[Google Scholar] [CrossRef] 
[35] D’Souza, S., James, E., Swarup, R., Mahuvakar, S., Pradhan, A. and Gupta, K. (2020) Algorithmic Approach to Diagnosis and Management of Post-Refractive Surgery Dry Eye Disease. Indian Journal of Ophthalmology, 68, 2888-2894.
[Google Scholar] [CrossRef] 
[36] 申海静, 陈铁红. 玻璃酸钠联合环孢素A治疗混合型干眼症的疗效观察[J]. 国际眼科杂志, 2020, 20(6): 1031-1034.
[37] Anitua, E., Muruzabal, F., de la Fuente, M., Riestra, A., Merayo-Lloves, J. and Orive, G. (2016) PRGF Exerts More Potent Proliferative and Anti-Inflammatory Effects than Autologous Serum on a Cell Culture Inflammatory Model. Experimental Eye Research, 151, 115-121.
[Google Scholar] [CrossRef] [PubMed]
[38] Merayo-Lloves, J., Sanchez-Avila, R.M., Riestra, A.C., Anitua, E., Begoña, L., Orive, G., et al. (2016) Safety and Efficacy of Autologous Plasma Rich in Growth Factors Eye Drops for the Treatment of Evaporative Dry Eye. Ophthalmic Research, 56, 68-73.
[Google Scholar] [CrossRef] [PubMed]
[39] Merayo-Lloves, J., Sanchez, R.M., Riestra, A.C., Anitua, E., Begoña, L., Orive, G., et al. (2015) Autologous Plasma Rich in Growth Factors Eyedrops in Refractory Cases of Ocular Surface Disorders. Ophthalmic Research, 55, 53-61.
[Google Scholar] [CrossRef] [PubMed]
[40] 吴雪梅, 杨淑焕. rb-bFGF联合羟糖甘滴眼液对准分子激光原位角膜磨镶术后干眼症状及泪液IL-1β、TGF-β1水平的影响[J]. 广西医科大学学报, 2019, 36(9): 1434-1437.
[41] Ma, K., Yan, N., Huang, Y., Cao, G., Deng, J. and Deng, Y. (2014) Effects of Nerve Growth Factor on Nerve Regeneration after Corneal Nerve Damage. International Journal of Clinical and Experimental Medicine, 7, 4584-4589.
[Google Scholar] [CrossRef] 
[42] 林颖, 苏焕钧, 张霞, 袁牧之. 口服维生素D3治疗飞秒激光辅助LASIK术后干眼[J]. 中华眼视光学与视觉科学杂志, 2021, 23(9): 700-706.
[43] Wei, R. and Christakos, S. (2015) Mechanisms Underlying the Regulation of Innate and Adaptive Immunity by Vitamin D. Nutrients, 7, 8251-8260.
[Google Scholar] [CrossRef] [PubMed]
[44] Askari, G., Rafie, N., Miraghajani, M., Heidari, Z. and Arab, A. (2020) Association between Vitamin D and Dry Eye Disease: A Systematic Review and Meta-Analysis of Observational Studies. Contact Lens and Anterior Eye, 43, 418-425.
[Google Scholar] [CrossRef] [PubMed]
[45] Jones, L., Downie, L.E., Korb, D., Benitez-Del-Castillo, J.M., Dana, R., Deng, S.X., et al. (2017) TFOS DEWS II Management and Therapy Report. The Ocular Surface, 15, 575-628.
[Google Scholar] [CrossRef] [PubMed]
[46] Anitua, E., Muruzabal, F., de la Fuente, M., Merayo, J., Durán, J. and Orive, G. (2016) Plasma Rich in Growth Factors for the Treatment of Ocular Surface Diseases. Current Eye Research, 41, 875-882.
[Google Scholar] [CrossRef] [PubMed]
[47] Schallhorn, C.S., Schallhorn, J.M., Hannan, S. and Schallhorn, S.C. (2017) Effectiveness of an Eyelid Thermal Pulsation Procedure to Treat Recalcitrant Dry Eye Symptoms after Laser Vision Correction. Journal of Refractive Surgery, 33, 30-36.
[Google Scholar] [CrossRef] 
[48] Vigo, L., Giannaccare, G., Sebastiani, S., Pellegrini, M. and Carones, F. (2019) Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction. Journal of Visualized Experiments, 146.
[Google Scholar] [CrossRef] [PubMed]
[49] 干眼强脉冲光临床应用专家共识专家组, 中国康复医学会视觉康复专委会干眼康复专业组. 强脉冲光治疗睑板腺功能障碍及其相关干眼专家共识(2022) [J]. 中华实验眼科杂志, 2022, 40(2): 97-103.
[50] Nemet, A., Mimouni, M., Hecht, I., Assad, N. and Kaiserman, I. (2020) Post Laser-Assisted in-Situ Keratomileusis Dry Eye Disease and Temporary Punctal Plugs. Indian Journal of Ophthalmology, 68, 2960-2963.
[Google Scholar] [CrossRef] 
[51] Lee, J.H., Han, K., Kim, T.H., Kim, A.R., Kwon, O., Kim, J.H., et al. (2021) Acupuncture for Dry Eye Syndrome after Refractive Surgery: A Randomized Controlled Pilot Trial. Integrative Medicine Research, 10, Article ID: 100456.
[Google Scholar] [CrossRef] [PubMed]

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