| Objective: Comparison of femtosecond laser-assisted laser in situ keratomileusis(FSLASIK)and intraocular lens implantation(ICL)implantation The effect of light surgery on ocular surface and meibomian gland function.Methods: A total of 84 patients with myopia corrected by FS-LASIK corneal refractive surgery or posterior chamber intraocular lens ICL implantation from July 2017 to October2018 in the Department of Ophthalmology,Sichuan Provincial People's Hospital were collected by prospective cohort study.Among them,FS-LASIK group had 64 cases of 127 eyes,and ICL group had 20 cases of 40 eyes.All patients underwent routine examinations and observations before surgery.The indicators included: Uncorrected Visual Acuity(UCVA),Best Corrected Visual Acuity(BCVA),Ocular Surface Disease Index(OSDI),corneal fluorescence staining,tear break up time(TBUT),Schirmer I test(SIT),mean lipid layer thickness(LLT),incomplete blink rate(IBR),Meibomian Gland Yielding Liquid Secretion(MGYLS),Meibomian Gland Yielding Secretion Score(MGYSS),mesangial gland loss rate.Three follow-ups were performed at 1 week,1 month,and 3 months after surgery,and changes in all indicators were observed and recorded.Results: The three months follow-ups of UCVA after surgery were significantly higher than those before surgery(P<0.05),and there was no significant difference between the two groups.There were no significant differences between the two groups in the three months follow-ups of BCVA after operation(P>0.05).The OSDI questionnaires in the FALAISK group were significantly higher than those before surgery(P<0.05),while the ICL group was only increased 1 week after surgery,and the difference in OSDI scores between the two groups after follow-up was statistically significant(F=11.839,P<0.001).The two groups were increased at 1 week after fluoroscopy,and the difference was statistically significant(P<0.05).There was no significant difference in Oxford Scheme between the two groups after follow-up(F=0.463,P=0.497).The follow-up of TBUT in FS-LASIK group was lower than that before operation(P<0.05),but there was no significant change in ICL group.The difference of TBUT between the two groups was statistically significantF=12.974,P<0.001).The Schirmer test in both groups was lower than that in the first week and the first month after surgery(P<0.05),while the FS-LASIK group lasted until 3 months after surgery,and there was no significant difference between the two groups after followup in the influence of the Schirmer test(F=0.070,P=0.792).The 3 times follow-up of LLT in the FS-LASIK group was lower than that before surgery(P<0.05),but the difference between the fllow-up and before surgery of ICL group was not obvious,and the difference between the two groups after follow-up was not statistically significant(F=0.068,P=0.795).For the incomplete blink rate,only 1 week after surgery in the FS-LASIK group was different from that before surgery(P<0.05).The follow-up about 1 week,1 month,and 3 months after surgeryin the FS-LASIK group.the MGYLS were decreased compared with the preoperative group(P<0.05).The difference between the fllow-up and before surgery of ICL group was not obvious,and there was no significant difference in the effect of MGYLS between the two groups after follow-up(F=0.620,P=0.432).After the analysis of secreted lipids,MGYSS in the FS-LASIK group followed up for 3 times was lower than before surgery(P<0.05),but there was no significant difference between the before surgery and follow-up in ICL group.but there was no statistical difference in MGYSS between the two groups after follow-up(F=0.519,P=0.472).There was no significant difference in the rate of meibomian gland loss between the two groups at 3 postoperative follow-up.Conclusion:Both surgical methods have good safety and effectiveness in the correction of myopia.The effect of FS-LASIK surgery on ocular surface and meibomian gland function is significant compared with posterior chamber intraocular lens ICL implantation,and this effect persists long time. |
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