非穿透性小梁手术联合角膜基质透镜植入术对原发性开角型青光眼患者眼表的影响  

The effect of NPTS combined with corneal stromal lenticule implantation on the ocular surface of patients with primary open-angle glaucoma

作　　者：刘雪珂 马敏丽 李文静 王慧娴 刘毅 甘霈 杨燕川 阿布都萨塔尔·艾山 李霞 Liu Xueke;Ma Minli;Li Wenjing;Wang Huixian;Liu Yi;Gan Pei;Yang Yanchuan;Aishan Abudusataer;Li Xia(Graduate School of Xinjiang Medical University,Urumqi 830054,China;Xinjiang 474 Hospital,830013,China;Graduate School of Shihezi University,832003,China)

机构地区：[1]新疆医科大学研究生学院,乌鲁木齐830054 [2]新疆四七四医院,830013 [3]石河子大学研究生院,832003

出　　处：《临床眼科杂志》2025年第1期44-49,共6页Journal of Clinical Ophthalmology

基　　金：新疆军区总医院北京路医疗区重点扶持科研项目(2022jzbj118、2021jzbjl001、2021jzbj1022、2020jzbj1002);新疆军区总医院北京路医疗区青年培育科研项目(2021jzbjl020);乌鲁木齐市卫生计生委科技计划项目(201841)

摘　　要：目的探讨非穿透性小梁手术(NPTS)联合角膜基质透镜植入术对原发性开角型青光眼(POAG)患者眼表的影响。方法 前瞻性病例对照研究。选取我院2020年9月至2022年12月诊治的POAG患者61例(80只眼),根据手术方式分为两组,观察组为NPTS联合角膜基质透镜植入术组,对照组为小梁切除术组。观察组29例(40只眼),对照组34例(40只眼),其中有2例患者一眼行NPTS联合角膜基质透镜植入术,另一眼行小梁切除术。比较两组患者术前1d和术后1周、1个月、3个月的眼表疾病指数(OSDI)评分、泪膜破裂时间(BUT)、泪液分泌试验I (SIt)、睑板腺缺失评分、结膜印迹细胞学Nelson分级及杯状细胞密度,并对结果进行分析。结果 两组患者术后1周的OSDI评分,BUT,SIt,Nelson分级,杯状细胞密度与术前相比差异均有统计学意义(均P<0.05),睑板腺评分差异无统计学意义(P>0.05),观察组的OSDI评分,BUT,杯状细胞密度变化幅度明显小于对照组(均P<0.05)。术后1个月两组OSDI评分,BUT、SIt、Nelson分级,杯状细胞密度均有所恢复。术后3个月观察组OSDI评分、睑板腺评分、Nelson分级、杯状细胞密度与术前相比差异均无统计学意义(均P> 0.05),而对照组与术前相比差异均有统计学意义(均P <0.05),观察组BUT、SIt较术前有所改善(均P <0.05),对照组均恢复至术前水平(均P> 0.05)。结论 NPTS联合角膜基质透镜植入术较小梁切除术对POAG患者的眼表早期影响更小,术后眼表恢复更快。Objective To investigate the effect of non-penetrating trabecular surgery(NPTS)combined with cor-neal stromal lenticule implantation on the ocular surface of patients with primary open angle glaucoma.MethodsThe pro-spective case-control study.80 eyes of 61 patients with primary open angle glaucoma were enrolled and divided into two groups according to the surgical method.The observation group was NPTS combined with corneal stromal lenticule implan-tation,and the control group was trabeculectomy.There were 29 patients(40 eyes)in the observation group and 34 pa-tients(40 eyes)in the control group.Two patients underwent NPTS combined with corneal lenticule implantation in one eye and trabeculectomy in the other eye.The ocular surface disease index score(OSDI),break-up time(BUT),schirmer I test(SIt),meibomian gland loss score,Nelson grade of conjunctival impression cytology and goblet cell density were com-pared between the two groups at 1 day before the surgery and at 1 week,1 month and 3 months after the surgery.Results The OSDI score,BUT,SIt,Nelson grade,and goblet cell density of the two groups at 1 week after the operation were sig-nificantly different from those before the operation(P<0.05),and there was no significant difference in meibomian gland score(P>0.05).The changes in OSDI score,BUT and goblet cell density in the observation group were significantly smaller than those in the control group(P<0.05).The OSDI score,BUT,SIt,Nelson grade,and goblet cell density were improved in both groups 1 month after the operation.There was no significant difference in OSDI score,meibomian gland score,Nelson grade and goblet cell density in the observation group at 3 months after the operation compared with those be-fore the operation(P>0.05),while there was a significant difference in the control group compared with those before the operation(P<0.05).The BUT and SIt in the observation group were improved compared with those before the operation D0I:10.3969/j.issn.1006-8422.2025.01.009(P<0.05).The control group recovered

关 键 词：非穿透性小梁手术 小梁切除术 角膜基质透镜 眼表 原发性开角型青光眼 

分 类 号：R779.6[医药卫生—眼科]