目的:为了寻求安全、简便、经济、有效切除结膜松弛症的手术方法,评价结膜松弛症定量定位切除术和新月形切除术的临床疗效。方法:采用前瞻性随机分组对照研究方法,将2008-01/2009-05在上海中医药大学附属普陀医院眼科按照结膜松弛症诊断标准入选手术治疗患者30例30眼按患者入选编号末位数的奇偶数随机分为两组。奇数组行结膜定量定位切除术15例15眼;偶数组行结膜新月形切除术手术15例15眼。手术后第2,4,8wk分别随访患者症状改善程度,裂隙灯观察结膜松弛症变化情况,测量泪河、BUT,氯霉素眼液尝味试验。结果:结膜松弛症定量定位切除仪和结膜新月形切除术组术后4wk,两组症状改善有效率均为87%,无差异。结膜定量定位切除术松弛结膜完全消除,占87%;结膜新月形切除术组松弛结膜完全消除,占73%,差异无统计学意义(χ2=0.833,P=0.361)。结膜定量定位切除术后4wk泪河恢复正常者,占87%,BUT≥10s者,占73%,氯霉素眼液尝味试验阳性者,占53%。结膜新月形切除术后4wk泪河恢复正常者,占73%(χ2=0.833,P=0.361),BUT≥10s者,占67%(χ2=0.159,P=0.690),氯霉素眼液尝味试验阳性者,占60%(χ2=0.136,P=0.713),差异均无统计学意义。结论:结膜松弛症定量定位切除术安全、简便、准确、有效,更适合手术经验不足的医师开展。

AIM: To find a safe, simple resection and cost-effective method for the surgical treatment of conjunctivochalasis through a prospective study with randomized comparison observation on the efficacy of treatment device for conjunctivochalasis oriented and quantitative resection. METHODS: Thirty conjunctivochalasis patients 30 eyes with standard diagnosis criteria in department of Ophthalmology of the Affiliated Putuo Hospital of Shanghai University of Traditional Chinese Medicine from Jan. 2008 to May. 2009 were recruited. Patients were randomly grouped according to the odd or even of the last number of the coding. 15 patients(15 eyes) in odd group received oriented resection and 15 patients(15 eyes) in even group received crescented resection.The improve-ment degrees of symptom release were observed 2,4 and 6 weeks after operation and tears river, BUT and Tasting of chloram-phenicol test essay were tested. RESULTS: The efficacy of symptom release in week 4 was 87% in patient group receiving oriented and quantitative resection with conjunctivochalasis treatment device. The cure rate of conjunctivochalasis in patient group receiving oriented and quantitative resection with conjunctivochalasis treatment device was 87% while 73% in patient group receiving crescented resection. There’s no significant difference(χ2=0.833, P=0.361). In patient group receiving oriented and quantitative resection with conjunctivochalasis treatment device, 87% patients were with recovery of tears river in week 4, 73% patients with BUT≥10 seconds, 53% patient with Tasting of chloram-phenicol test essay positive. In patient group receiving crescented resection, 73% patients were with recovery of tears river in week 4 (χ2 =0.833, P=0.361), 67% patients with BUT≥10 seconds (χ2=0.159, P=0.690), 60% patient with Tasting of chloramphenicol test essay positive (χ2=0.136, P=0.713). There’s no significant difference. CONCLUSION: Both operation by conjunctivochalasis treatment device for oriented and quantitative resection and conjunctivochalasis crescented resection are effective while operation by conjunctivochalasis treatment device for oriented and quantitative resection is more simple and accurate, it’s more suitable for physician with less operation experience.

R779.6

中国上海市普陀区科委自主创新科研基金项目(No.2008B-88)~~