复发性翼状胬肉切除角膜缘重建术后泪膜功能变化  

Tear functions changes after keratolimbal reconstruction in patients with recurrent pterygiurn

作　　者：李竑[1] 贾长伟[1] 

机构地区：[1]山东省滨州市中心医院眼科,251700

出　　处：《中国实用眼科杂志》2010年第12期1308-1311,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 评价角膜缘重建术治疗复发性翼状胬肉手术前后泪膜功能的变化.方法 对30例（30只眼）单侧复发性翼状胬肉患者实施翼状胬肉切除、自体健眼角膜缘联合球结膜片移植术,重建角膜缘屏障功能.进行全面的眼科查体及相关的全身查体,排除睑板腺功能障碍、糖尿病、类风湿性关节炎及甲状腺机能亢进等影响泪液膜功能的疾病;记录术前1天及术后1月、2月、3月泪膜破裂时间（BUT）、基础泪液分泌试验（Schirmer Ⅰ testS Ⅰt）、角膜荧光素染色（FL）的结果.术前与健眼对照;术后不同时间结果与术前对照.结果 术前与健眼比较：患眼的BUT明显缩短（P＜0.01）、S Ⅰ t明显减少（P＜0.01）、FL评分明显高于健眼（P＜0.01）.患眼手术前后比较：术后1个月：三项试验与术前无统计学意义（P＞0.05）.术后2个月情况：BUT明显延长（P＜0.01）,S Ⅰt比术前增加（P＜0.01）,FL评分比术前显著降低（P＜0.01）;但该时期的测试结果与健眼：BUT及FL评分仍存在差异（P＜0.01）,而S Ⅰt已接近健眼水平（P＞0.05）.术后3个月：三项试验已恢复到健眼水平（P＞0.05）.结论 复发性翼状胬肉患者常合并泪膜功能异常,而翼状胬肉切除并角膜缘重建术可使患眼的泪膜功能得到很大程度的改善.Objective To evaluate the short-term effects of recurrence pterygium excision combined with keratolimbal reconstruction technique on tear function. Methods Thirty patients with unilateral recurrent pterygium who underwent pterygium excision combined with the limbal-comeal and conjunctival autografting were enrolled in this study. All patients were examined to rule out any other ocular or extraocular disease and drug affecting tear functions. Tear break-up time （BUT）, the basic tear secretion （Schirmer Ⅰ test, S Ⅰ t） and fluorescein staining （FL） were observed in patients before and 1 month, 2 and 3months after surgery. Results At 1 day before surgery, the eyes with recurrence pterygium were a shorter BUT, more decreased S Ⅰ t and more increased FL score than the opposite healthy eyes （P 〈0.01 ）. At 1 month postoperation, there was no significant difference in three tests when compared with the preoperation （P 〉0.05）. At 2 months postoperation, the BUT prolonged, S Ⅰ t increased and FL decreased when compared with preoperation （P 〈0.01）; but compared with the opposite healthy eyes, the BUT and FL in 2 months after surgery were still significant difference （P〈0.01）,and the S Ⅰ t had no difference （P 〉0.05）. At 3 months postoperation, there was no difference in three tests when compared with the healthy eyes. Conclusions Tear function is abnormal in patients with recurrence pterygium. The tear functions in patients with recurrent pterygium can improve after pterygium excision combined with keratolimbal reconstruction.

关 键 词：复发性翼状胬肉 角膜缘重建术 泪膜 

分 类 号：R777.33[医药卫生—眼科]