应用眼表分析仪研究原发性翼状胬肉患者眼表变化  

Ocular surface change of primary pterygium with OCULUS keratograph

作　　者：李中庭 冷炫 张艳莉[1,2] 胡婷欣 赵岐 余敏斌[1] Li Zhongting;Leng Xuan;Zhang Yanli;Hu Tingxin;Zhao Qi;Yu Minbin(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangzhou 510060,China;Department of Ophthalmology,Zhongshan City People 's Hospital,Zhongshan Hospital of Sun Yat-sen University,Zhongshan 528400,China)

机构地区：[1]中山大学中山眼科中心眼科学国家重点实验室,510060 [2]中山市人民医院眼科医疗中心,528400

出　　处：《中华实验眼科杂志》2018年第12期942-945,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：广东省科技计划项目(2014A020212052);广州市科技计划项目(2014Y2-00172);中山市科技计划项目(20122A003、2015B1115).

摘　　要：目的应用眼表分析仪检测原发性翼状胬肉患者的临床表现及体征,分析翼状胬肉与眼表各参数间的相关性。方法采用前瞻性病例观察研究设计,选取2016年6-9月于中山市人民医院门诊就诊的原发性翼状胬肉患者39例55眼,测量翼状胬肉侵入角膜面积并记录发病时间;通过角膜荧光素染色观察眼表情况,且用眼表分析仪检测泪膜破裂时间(BUT)及睑板腺功能评分。结果翼状胬肉侵入角膜面积为2-20mm^2,平均5(3,10)mm^2;翼状胬肉的发病时间为3~8年,平均5(4,6)年;BUT为2.1-15.0s,平均(6.3±3.0)s;睑板腺评分为0-4分,平均2(1,3)分。翼状胬肉侵入面积与发病时间无明显相关性(r=0.197,P=0.148),与BUT呈负相关(r=-0.711,P<0.001),与睑板腺评分呈正相关(r=0.554,P<0.001)。82%(45/55)的患者泪膜破裂斑最早出现于翼状胬肉头部附近。结论眼表分析仪能够直观、非接触性、无创地评价翼状胬肉患者眼表状况。通过观察翼状胬肉侵入角膜的面积评估患者的眼表损害情况可为翼状胬肉患者的治疗提供参考。Objective To study the correlation between pterygium area and the clinical manifestation and signs of primary pterygium obtained from OCULUS Keratograph. Methods A prospective case observation study was performed. Thirty.nine ( 55 eyes ) primary pterygium patients were selected from June to September 2016 in Zhongshan People's Hospital. The area of the pterygium invaded cornea and duration of pterygium were recorded. The ocular surface condition was detected by corneal fluorescein staining. The break up time of tear film ( BUT) and the gland function score were measured with OCULUS Keratograph. This study was approved by the Ethics Committee of Zhongshan People's Hospital ( 2015 [ 13 ] ) . All operations followed the Helsinki Declaration and all patients signed informed consent forms. Results The areas of pterygium invaded cornea was 2-20 mm2,the mean size was 5(3, 10)mm2;the duration of pterygium was 3-8 years,the mean duration was 5(4,6)years;the BUT was 2. 1-15. 0 seconds,the mean BUT was (6. 3±3. 0) seconds. The mean gland function score was 2(1,3). The area of pterygium was not significantly correlated with the duration of pteryguim (r=0.197,P=0.148),while it was negatively correlated with BUT (r=-0. 711, P<0. 001 ) and positively correlated with the tarsal gland score (r=0. 554,P<0. 001). What's more,82% (45/55 eyes) of the patients' tear film rupture appeared firstly near pterygium's head. Conclusion OCULUS Keratograph can directly evaluate the ocular surface condition of pterygium patients in a non. contact and non.invasive method. Assessing the ocular surface damage by observing the area of pterygium invaded cornea may provide a prospective treatment for pterygium patients.

关 键 词：翼状胬肉 眼表分析仪 泪膜破裂时间 

分 类 号：R777.33[医药卫生—眼科]