目的比较不同角膜瓣蒂位置飞秒准分子激光原位角膜磨镶术(FS-LASIK)治疗近视后的术后视力、像差及干眼程度。方法采取制作角膜瓣蒂右眼于鼻侧,左眼于上方的对照研究,比较在我院行飞秒准分子激光原位角膜磨镶术患者22例44只眼,平均年龄20.820±3.460岁,其中男性11例,女性11例,分别于术前、术后1周、术后1月、术后3月行视力、屈光度检查、波前像差检查,应用Oculus眼表综合分析仪客观评价泪河高度、非侵袭式第一次泪膜破裂时间、平均泪膜破裂时间,以及Schirmer I test和主观症状(McMonniesQuestionnaire)评分。结果患者术后1周、术后1月、术后3月裸眼视力鼻侧蒂眼分别为5.050±0.086,5.096±0.084,5.109±0.111,上方蒂眼分别为 5.036士0.090,5.052±0.116,5.082±0.130(P=0.610,0.166,0.457)差异无统计学意义,残余屈光度鼻侧蒂眼分别为0.046±0.166(D),0.011±0.053(D),0.068士0.220(D),上方蒂眼分别为 0.014±0.121(D),0.046±0.227(D),0.034士0.178(D)(P=0.202,0.496,0.575)差异无统计学意义,高阶像差鼻侧蒂眼分别为0.522±0.148(um),0.508±0.189(um),0.540±0.136(um),上方蒂眼分别为 0.508±0.141(um),0.555±0.168(um),0.548±0.151(um)(P=0.756,0.390,0.843)差异无统计学意义,泪河高度鼻侧蒂眼分别为 0.208±0.065(mm),0.206±0.056(mm),0.211±0.060(mm),上方蒂眼分别为0.213±0.091(mm),0.195±0.059(mm),0.216±0.067(mm)(P=0.850,0.530,0.760)差异无统计学意义,非侵袭式第一次泪膜破裂时间鼻侧蒂眼分别为6.096±3.528(s),6.861±4.694(s),6.631±3.516(s),上方蒂眼分别为 6.190±3.751(s),5.740±4.274(s),7.436±4.363(s)(P=0.932,0.412,0.504)差异无统计学意义,非侵袭式平均泪膜破裂时间鼻侧蒂眼分别为 8.553±3.486(s),8.838±5.104(s),9.130±4.047(s),上方蒂眼分别为 7.986±3.676(s),8.284±4.384(s),9.130士4.047(s)(P=0.602,0.701,0.677)差异无统计学意义,Schirmer I test鼻侧蒂眼分别为13.140±8.768(mm),15.140±9.213(mm),13.410±9.122(mm),上方蒂眼分别为 12.270±9.686(mm),13.860±8.860(mm),14.500±8.573(mm)(P=0.758,0.643,0.685)差异无统计学意义,McMonnies Questionnaire 鼻侧蒂眼分别为 7.950±2.952,8.140±2.624,6.631±3.516,上方蒂眼分别为为 8.090±2.724,5.740±4.274,7.436±4.363(P=0.874,0.864,0.647)鼻侧蒂和上方蒂眼差异无统计学意义。结论飞秒准分子激光原位角膜磨镶术角膜瓣蒂位于鼻侧和上方对于术后视力、像差及干眼程度差异无统计学意义。