Department of Ophthalmology, the First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
National Natural Science Foundation of China;Hainan Provincial Natural Science Foundation of China
玻璃体切除术的问世解决了眼科界难以攻克且难治性眼底病的治疗，微创玻璃体切除术（minimally invasive vitrectomy，MIV）是治疗眼底疾病的主要手术方式。临床中，患者在接受微创玻璃体切除术后出现干眼症状，包括流泪、异物感和视觉障碍等。笔者推测微创玻璃体切除术可能会损伤结膜及角膜上皮以及相关感觉神经，以及破坏泪膜而引起局部炎症反应，从而影响眼表微环境,诱发或加重干眼症状。目前，对于微创玻璃体切除术后眼表变化的相关研究较少。本文旨在分析微创玻璃体切除术术前、术中、术后不同因素对于眼表微环境的影响，并针对不同情况提供可采取的防治措施,以便于指导临床做好术前准备,选择合适的手术方式以及减少术后罹患干眼风险。
The introduction of vitrectomy has solved a difficult and intractable problem in the ophthalmology community for the treatment of fundus oculi diseases. To date, minimally invasive vitrectomy (MIV) is the main surgical modality for the treatment of fundus oculi diseases. Clinically, patients develop dry eye symptoms after MIV, including lacrimal irritation, foreign body sensation, and visual disturbances. We speculates that MIV may damage the conjunctival and corneal epithelium as well as related sensory nerves, disrupting the tear film and causing a local inflammation response, thereby further affecting the ocular surface microenvironment and inducing or aggravating existing dry eye symptoms. At present, there are few studies on the changes of ocular surface after MIV. This article aims to analyze the effects of different factors on the microenvironment of the ocular surface before, during and after MIV, and to provide preventive and curative measures that can be taken to guide the clinic to make good preparations for the operation, to choose the appropriate surgical procedure, and to reduce the risk of dry eye in the postoperative period.