青光眼小梁切除术后功能性滤过泡形态与眼表改变相关性分析  

Correlation between the morphology of functional filtering blebs and ocular surface changes in glaucoma patients after trabeculectomy

作　　者：李轩[1,2,3,4,5] 郝朋[1,2,3,4,5] 姜志昕[1,2,3,4,5] 

机构地区：[1]天津市眼科医院,天津300020 [2]天津市眼科学与视觉科学重点实验室,天津300020 [3]天津市眼科研究所,天津300020 [4]天津医科大学眼科临床学院,天津300020 [5]南开大学眼科医院,天津300020

出　　处：《中国实用眼科杂志》2013年第9期1116-1118,共3页Chinese Journal of Practical Ophthalmology

基　　金：天津市应用基础与前沿技术研究计划项目（11JCYBJC27200）

摘　　要：目的分析青光眼小梁切除术后功能性滤过泡眼的眼表改变，以及滤过泡形态与眼表变化的相关性。方法20只眼青光眼小梁切除术后6个月以上的功能性滤过泡眼（滤过泡组）及20只正常眼（对照组）分别行眼表评估包括角膜荧光素染色、泪膜破裂时间（BUT）、Schirmer I检测及泪膜干涉成像仪检查，探究功能性滤过泡眼与正常对照眼的眼表改变及滤过泡形态与BUT、SchirmerI检测、角膜荧光素染色及泪膜干涉图像等级的关系。结果功能性滤过泡眼表现为BUT缩短（P〈0．01），角膜荧光素染色分级增加（P〈0．05），Schirmer I检测值高于对照组（P〈0．05）。滤过泡高度与BUT呈负相关（rs=-0．668，P〈0．01）；而与角膜荧光素染色呈正相关（rs=0．585，P〈0．01）。结论青光眼小梁切除术后滤过泡可影响眼表的稳定性，引起轻微干眼样症状。Objective To investigate the effects of glaucoma filtering blebs on the tear film and ocular surface epithelium after trabeculectomy, and to explore the correlation between the morpholo-gy of bleb and the changes of tear film. Methods Twenty eyes of 20 glaucomatous patients with functioning blebs after more than 6 months trabeculectomy （bleb-group） and 20 normal control sub- jects （control） underwent fluorescein staining of corneal, measurement of tear film break-up-time （BUT） and Schirmer I test as well as the examination of tear film pattern by DR-I tear interferome-try. The parameters of each measurement were compared between the bleb-group and the control. The relationships between the morphology of bleb and the parameters of ocular surface were ana-lyzed. Results Eyes with functioning blebs presented minimal, but significantly lower BUT value than controls. Schirmer I test and the fluorescein staining of cornea showed higher in bleb-group as compared with controls （P 〈0.05）. Bleb height showed correlation with BUT （rs=-0.668, P 〈0.01） and fluorescein staining of corneal （rs=0.585, P 〈0.01）. Conclusions Filtering blebs can interfere with the ocular surface stability causing few dry eyes like signs.

关 键 词：泪膜 青光眼 滤过手术 干眼症 眼表结构 

分 类 号：R779.6[医药卫生—眼科]