湿房镜对蒸发过强型干眼患者泪膜稳定性的影响  

Effect of moisture chamber spectacles on tear film stability of patients with evaporative dry eye

作　　者：沈光林[1] 马晓萍[1] 

机构地区：[1]复旦大学附属中山医院眼科,上海200032

出　　处：《中国实用眼科杂志》2015年第10期1127-1131,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨湿房镜对蒸发过强型干眼（evaporative dry eye，EDE）泪膜稳定性的影响，并评价湿房镜的临床治疗效果。方法前瞻I生临床研究。于2014年8-12月在复旦大学附属中山医院眼科就诊的30例EDE患者并随机分成两组：湿房镜组（15例）和0．1％玻璃酸钠滴眼液对照组（15例），所有患者均查右眼。在基线（baseline）对患者进行泪河高度（tear meniscus height，TMH）、非侵入式泪膜破裂时间（non—invasive tear break—up time，NIBUT）和泪膜脂质层（tear film lipid layer，TFLL）检查。基线检查完毕后，检查者指导湿房镜组患者配戴湿房镜共90min，在对照组患者右眼滴入一滴无防腐剂的玻璃酸钠滴眼液。之后每隔15min重复检测上述指标，共测7次（base．1ine，15、30、45、60、75、90min）。结果TMH、NIBUT在配戴湿房镜之后，随着时间逐渐增加，并在45～60min达到最大值，在75min和90min逐渐下降，但仍然高于基线值，差异有统计学意义（P〈0．05）。TMH、NIBUT在各时间点的组内及组间比较差异有统计学意义（P〈0．05）。湿房镜组TFLL明显增加，而对照组无明显变化。结论湿房镜可以增强EDE患者的泪膜稳定性，湿度在泪膜脂质层的扩散和泪膜整合过程中发挥重要作用，湿房镜是治疗EDE的有效方法。Objective To determine the effect of moisture chamber spectacles （MCS） on tear film stability of patients with evaporative dry eye （EDE）. Methods In this prospective single-center study, a total of 30 patients with EDE were recruited and randomly divided into two groups： MCS group （n =15） and control group （n =15） with preservative-free sodium hyaluronate 0.1%. Measure- ments were performed in the right eye in all patients. Tear meniscus height （TMH）, non-invasive tear break-up time （NIBUT） and tear film lipid layer （TFLL） were measured at baseline. After base- line measurement, subjects in the MCS group were required to wear MCS for a total of 90 min- utes. While subjects in the control group immediately received a single sodium hyaluronate eye drop in the right eye. Then measurements were repeatedly performed at 15 minutes intervals over a peri- od of 90 minutes （baseline, 15, 30, 45, 60, 75, 90 minutes）. Results TMH and NIBUT continuously increased over time after wearing MCS, and reached the maximum at 60 minutes, then slowly decreased at 75 minutes and 90 minutes, but still remained higher than baseline values （P 〈0.05）. There were significant differences in TMH and NIBUT in the MCS group compared with control group （P 〈0.05）. TFLL were significantly increased in MCS group, but no changes were observed in the control group. Conclusions Wearing MCS significantly improve tear film stability in patients with EDE. Humidity may play a key role in the theology of tear film lipid layer spread. This study supports clinical evidence of MCS as an effective treatment of EDE.

关 键 词：湿房镜 干眼 泪膜稳定性 泪膜破裂时间 

分 类 号：R77[医药卫生—眼科]