目的：应用Keratograph 5M比较飞秒激光与传统LASIK术后干眼症状和体征的变化。

方法：收集2017-06/11行角膜屈光手术患者60例120眼，其中行飞秒激光LASIK手术30例60眼，传统LASIK手术30例60眼，于术前和术后1wk，1、3、6mo进行眼科常规检查和Keratograph 5M干眼检查并完成眼表疾病指数(OSDI)问卷。

结果：术后1wk，两组OSDI评分均高于术前(P<0.01)，术后1mo两组均恢复到术前水平(P>0.05)。传统组术后1wk，1、3mo非侵入性泪膜破裂时间均比术前缩短(P<0.01)，飞秒激光组术后1wk，1mo泪膜破裂时间均比术前缩短(P<0.01)，术后3mo，飞秒激光组泪膜破裂时间均明显高于传统组(P<0.01)。术后1wk，1mo，两组泪河高度均较术前降低(P<0.01)，脂质层均较术前变薄(P<0.05)。

结论：无论飞秒激光制瓣LASIK还是传统LASIK术都可影响泪膜的稳定性，引起干眼症状，影响程度随术后时间逐渐减弱，但飞秒制瓣能更快恢复至术前水平。

METHODS: Sixty patients(120 eyes)who underwent corneal refractive surgery from June 2017 to November 2017 were enrolled. Thirty patients(60 eyes)underwent femtosecond-assisted laser LASIK and 30 patients(60 eyes)underwent conventional LASIK. All patients took examinations of Keratograph 5M dry eye related examinations,routine ophthalmological examinations and ocular surface disease index(OSDI)questionnaire before and 1wk, 1mo, 3mo and 6mo after surgery.

RESULTS: One week after operation, the OSDI scores of two groups were significantly higher than pre-operation(P<0.01), but 1mo after operation, the two groups recovered to the preoperative level(P>0.05). Noninvasive tear film break-up time(NI-BUT)in the conventional group was shorter 1wk, 1mo and 3mo after operation(P<0.01), while it was shorter in 1wk and 1mo after operation in femtosecond laser group(P<0.01). There was significant difference between conventional group and femtosecond laser group at 3mo after operation in NI-BUT(P<0.01). Tear meniscus hight(TMH)and the thickness of lipid layers of the two groups all decreased in 1wk and 1mo after operation(P<0.05).

CONCLUSION: Whether femtosecond-assisted or conventional LASIK will affect tear film stability and cause dry eye symptoms. The degree of influence decreases gradually with the time after operation, but femtosecond laser group can recover more quickly.