青光眼小梁切除术后泪膜的变化
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Changes of tear film after trabeculectomy in glaucoma
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    摘要:

    目的:了解青光眼小梁切除手术前后泪膜的变化,探讨青光眼小梁切除术后干眼的发病情况和防治措施。

    方法:对青光眼患者36例60眼在行小梁切除术前3d; 术后3,7,14,30d进行详细的眼科检查。检查内容包括:下睑中央泪河高度、泪膜破裂时间(break-up time, BUT)、基础泪液分泌试验(Schirmer Ⅰ test, SⅠt)、裂隙灯显微镜下角膜荧光素染色评分。

    结果:与术前相比,术后3,7d,下睑中央泪河高度下降,BUT缩短,SⅠt减少,角膜荧光素染色评分增加。大部分患眼术后14d,下睑中央泪河高度、BUT、SⅠt、角膜荧光素染色评分开始恢复,到术后30d,有22% 的患眼泪膜未能恢复至术前水平; 术前泪膜正常的患眼中有18%发生干眼症。

    结论:青光眼小梁切除术可影响泪膜的稳定性,部分患者出现明显的干眼症,应及时给予干预和治疗。

    Abstract:

    AIM: To learn the changes of the tear film before and after the trabeculectomy of glaucoma and explore the incidence of dry eye and the prevention and control measures.

    METHODS: The 36 patients(60 eyes)of glaucoma were examined in detail before 3d of trabeculectomy and after the surgery at 3, 7, 14 and 30d. The examinations include lower eyelid central river of tears, break-up time(BUT), Schirmer Ⅰ test(SⅠt)and staining scores of corneal fluorescein under slit lamp microscope.

    RESULTS:The tear meniscus height of central lower eyelid was increased and the tear film BUT was shortened at the same time, the scores of SⅠt was reduced and corneal fluorescein staining score was increased at postoperative 3 and 7d compared with that of preoperation. The tear meniscus height of central lower eyelid, tear film BUT and SIt and score of corneal fluorescein staining began to recover in most of the affected eyes after surgery 14d. At 30d after surgery, 22% of patients tear film failed to recover to the preoperative level; dry eye occured in 18% preoperative eyes with normal tear film.

    CONCLUSION:Trabeculectomy of glaucoma may affect the stability of the tear film and some patients showeing obvious dry eye and should be intervened and treatmented timely.

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李学军,刘伟.青光眼小梁切除术后泪膜的变化.国际眼科杂志, 2015,15(7):1201-1203.

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  • 收稿日期:2015-01-08
  • 最后修改日期:2015-06-16
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  • 在线发布日期: 2015-07-01
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