目的：探究飞秒激光与机械板层刀制瓣准分子激光原位角膜磨镶(LASIK)术对角膜瓣厚度稳定性和干眼症的影响。

方法：回顾性分析于本院眼科行LASIK术的近视患者80例160眼，根据制瓣方式不同分为飞秒激光组和机械板层刀组。测量术后两组患者不同时间点(1h，1d，1wk，1、3mo)的角膜瓣厚度，并比较不同方向上距离角膜顶点1、2、3mm及角膜顶点角膜瓣厚度的差异。比较患者术后1、3mo，1、2a OSDI评分和干眼症的发生率。

结果：飞秒激光组角膜瓣顶点厚度为99.62±4.50μm，机械板层刀组角膜瓣顶点厚度为125.25±12.81μm。飞秒激光制瓣不同离心点位置的角膜瓣厚度较为均匀，而机械板层刀制瓣角膜厚度变化较大。术后1、3mo，1、2a机械板层刀组OSDI评分高于飞秒激光组(P<0.01)。随访2a时间，飞秒激光组干眼发病率低于机械板层刀组(χ²=4.692，P=0.030)。术后1、2a，飞秒激光组轻度干眼所占比例高于机械板层刀组(P=0.044、0.001)。

结论：相对于机械板层刀制瓣，飞秒激光制瓣LASIK术患者的角膜瓣厚度稳定性更好，更为均匀，误差更小，且患者术后干眼的发生率更低，以轻度干眼为主。

METHODS: Retrospective analysis of 80 patients with myopia who underwent LASIK in our hospital. According to different methods of flapping, it is divided into femtosecond laser group and mechanical laminating knife group. The flap thickness of the two groups of patients at different time points(1h, 1d, 1wk, 1mo, 3mo)were measured. The differences in corneal apex 1, 2, 3mm and corneal apex flap thickness in different directions were compared. The incidence of dry eye syndrome was compared between 1 and 3mo, 1a, 2a after surgery.

RESULTS: The apex thickness of the corneal flap of the femtosecond laser group is 99.62±4.50μm, and the thickness of the apex of the mechanical lamellar knife group is 125.25±12.81μm.The thickness of the corneal flap at different centrifugal points of the femtosecond laser flap is relatively uniform, while the thickness of the corneal flap of the mechanical lamellar knife varies greatly. The OSDI scores of the mechanical lamellar group were higher than those of the femtosecond laser group at 1, 3, 1, and 2a postoperatively(P<0.01). At 2a of follow-up, the incidence of dry eye in the femtosecond laser group was lower than that in the mechanical lamellar group(χ²=4.692, P=0.030). At 1 and 2a postoperatively, the proportion of mild dry eye in the femtosecond laser group was higher than that in the mechanical lamellar group(P=0.044, 0.001).

CONCLUSION: Compared with the mechanical lamellar scalpel, the corneal flap thickness of patients with femtosecond laser LASIK is better, more uniform and less error. And the incidence of dry eye after surgery is lower, with mild dry eyes.