自然杂志 ›› 2025, Vol. 47 ›› Issue (6): 497-503.doi: 10.3969/j.issn.0253-9608.2025.06.010

• 科技进展 • 上一篇    下一篇

SMILE术后干眼及相关机制研究进展

武静,张朝阳,张敬法   

  1. ①上海交通大学附属同仁医院眼科,上海 200336;②香港中文大学(深圳)犇亚国际眼科研究所,广东深圳 518000
  • 收稿日期:2025-07-08 出版日期:2025-12-25 发布日期:2025-12-18
  • 基金资助:
    国家自然科学基金面上项目(82171062、82301222)和上海交通大学医学院虹桥国际医学院科研基金(HQYJY-2025-04)

Advances in postoperative dry eye after femtosecond laser small incision lenticule extraction and related mechanisms

WU Jing, ZHANG Chaoyang, ZHANG Jingfa②
  

  1. ① Department of Ophthalmology, Tongren Hospital Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China; ② The Primasia International Eye Research Institute of the Chinese University of Hong Kong (Shenzhen), Shenzhen 518000,Gu angdong Province, China
  • Received:2025-07-08 Online:2025-12-25 Published:2025-12-18

摘要:

近年来,飞秒激光小切口角膜基质透镜取出术(femtosecond laser small incision lenticule extraction, SMILE) 以其微创、舒适、安全有效的特点逐渐成为屈光矫正的主流手术之一。然而,与其他屈光矫正手术类似,患者SMILE术后也存在干眼症状,严重者可导致患者视觉质量下降。术中角膜神经损伤是导致患者术后干眼的主要原因。此外,炎症介质产生、黏蛋白分泌减少和睑板腺功能障碍等病理机制导致泪膜中水样层和脂质层分泌不足和眼表润滑度下降,加重泪膜不稳定和术源性干眼症。本文主要阐述SMILE术后干眼临床特点和发生机制,并探讨SMILE应用于既往干眼症患者的安全性和有效性,以期为患者提供更好的视觉质量。最后,本文就SMILE围手术期干眼症的预防和治疗进行了展望。

关键词:

Abstract:

In recent years, femtosecond laser small incision lenticule extraction (SMILE) has been one of the mainstream refractive correction surgeries due to its minimally invasive, comfortable, safe and effective advantages. However, similar to other refractive correction surgeries, patients after SMILE surgery also have postoperative dry eye symptoms. In severe cases, they can result in decreased visual quality for patients. Corneal nerve damage during SMILE surgery is the main cause of dry eye. Besides, other pathological mechanisms including generation of inflammatory mediators, reduction of mucin secretion, and meibomian gland dysfunction, etc., result in the reduced secretion of aqueous and lipid layers in tear film and decreased ocular surface lubrication, aggravating the instability of tear film and postoperative dry eye syndrome. This review mainly elaborates on the clinical characteristics and related mechanisms of dry eye after SMILE surgery, and explores the safety and efficacy of SMILE application in patients with dry eye syndrome, in order to provide better visual quality for patients. Lastly, the perioperative prevention and treatment of dry eye syndrome are proposed for patients undergoing SMILE surgery.