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1.
不同手术方式对翼状胬肉患者泪液功能的影响   总被引:1,自引:0,他引:1  
目的:探讨不同手术方式对翼状胬肉患者泪液功能的影响及其可能机制。方法:翼状胬肉患者50例50眼,随机分成两组,A组30例30眼行翼状胬肉切除联合带蒂结膜瓣移植术,B组20例20眼行翼状胬肉切除联合自体角膜缘干细胞移植术,分别于术前和术后1,3mo检查泪膜破裂时间(BUT)、SchirmerI试验、角结膜荧光素染色(CFS)、泪液羊齿状物试验(TFT),采用眼表疾病指数(OSDI)评价胬肉及胬肉切除术后泪液功能变化对患者生活质量的影响,并作统计学分析。结果:两组术后1moBUT缩短、CFS增多、OSDI变高、泪液羊齿结晶形成较差,和术前比较差异有显著意义(P<0.05),而术后1moSchirmerI和术前比较差异无显著意义。两组术后3moBUT,SchirmerI,CFS,OSDI,TFT和术前比较差异无显著意义。术后1moB组BUT较A组长,CFS较A组少,OSDI较A组高,泪液羊齿结晶形成较A组良好,差异有显著意义(P<0.05),而术后1mo两组SchirmerI比较差异均无显著意义。术后3mo两组BUT,SchirmerI,CFS,OSDI,TFT比较差异均无显著意义。结论:翼状胬肉切除术后早期对泪膜功能有影响,术后3mo泪膜功能恢复至术前水平。行翼状胬肉切除联合自体角膜缘干细胞移植术后早期对泪膜功能的影响小于翼状胬肉切除联合带蒂结膜瓣移植术。  相似文献   

2.
复发性翼状胬肉切除角膜缘重建术后泪膜功能变化   总被引:2,自引:0,他引:2  
目的 评价角膜缘重建术治疗复发性翼状胬肉手术前后泪膜功能的变化.方法 对30例(30只眼)单侧复发性翼状胬肉患者实施翼状胬肉切除、自体健眼角膜缘联合球结膜片移植术,重建角膜缘屏障功能.进行全面的眼科查体及相关的全身查体,排除睑板腺功能障碍、糖尿病、类风湿性关节炎及甲状腺机能亢进等影响泪液膜功能的疾病;记录术前1天及术后1月、2月、3月泪膜破裂时间(BUT)、基础泪液分泌试验(Schirmer Ⅰ testS Ⅰt)、角膜荧光素染色(FL)的结果.术前与健眼对照;术后不同时间结果与术前对照.结果 术前与健眼比较:患眼的BUT明显缩短(P<0.01)、S Ⅰ t明显减少(P<0.01)、FL评分明显高于健眼(P<0.01).患眼手术前后比较:术后1个月:三项试验与术前无统计学意义(P>0.05).术后2个月情况:BUT明显延长(P<0.01),S Ⅰt比术前增加(P<0.01),FL评分比术前显著降低(P<0.01);但该时期的测试结果与健眼:BUT及FL评分仍存在差异(P<0.01),而S Ⅰt已接近健眼水平(P>0.05).术后3个月:三项试验已恢复到健眼水平(P>0.05).结论 复发性翼状胬肉患者常合并泪膜功能异常,而翼状胬肉切除并角膜缘重建术可使患眼的泪膜功能得到很大程度的改善.  相似文献   

3.
PURPOSE: To investigate the effect of hormone replacement therapy (HRT) on postmenopausal tear function and the conjunctival epithelium. METHODS: Schirmer I-Jones test, tear film break-up time (BUT), and impression cytology findings were analyzed in 34 eyes of 17 women who were at least two years postmenopausal and not taking HRT: This series of tests was repeated after three months on HRT. RESULTS: The patients' average age was 53.82 +/- 3.6 years, and the mean time postmenopause was 35.29 +/- 11.59 months. There was no significant difference in the Schirmer I-Jones test results before and after three months of HRT (p > 0.05). However, the BUT (p < 0.05) and impression cytology (p < 0.05) findings were significantly affected by HRT. CONCLUSIONS: HRT may alleviate postmenopausal dry eye symptoms by increasing goblet cell density.  相似文献   

4.
目的:评价翼状胬肉切除联合带蒂结膜瓣移植术对翼状胬肉患者泪液功能的影响情况。 方法:对入选的翼状胬肉患者行胬肉切除联合带蒂结膜瓣移植手术,在术前1d;术后3,7d;术后1mo做泪膜破裂时间(BUT) 、泪液分泌(Schirmer Ⅰ)试验和泪液羊齿状试验(TFT),在术前1d和术后1mo做结膜印迹细胞学检查, 以评价患者术前、术后的泪液功能。 结果:共纳入87例87眼患者,其中男45例, 女42例。年龄45~81( 平均64.1±8.8)岁。术后1mo BUT较术前1d延长,分别为11.47±3.23s和9.43±3.25s (P<0.05);术前羊齿状试验结果正常(Ⅰ级和Ⅱ级)的患者占22%,术后1mo正常的患者增加至90%,术后1mo TFT较术前明显改善(P<0.05);术后杯状细胞密度要高于术前结膜杯状细胞密度,分别为39.73±18.46个/10个高倍镜和48.85±18.80/10个高倍镜 (P<0.05)。泪液分泌Ⅰ试验结果显示术后早期分泌较术前增多(P<0.05),但术前、术后晚期差异无显著意义(P>0.05) 。 结论:胬肉切除联合带蒂结膜瓣移植术手术前后的泪液功能明显有改变, 手术可使患者的泪液功能得到一定的恢复。  相似文献   

5.
Background Tear secretion and tear film stability seem to be influenced by pseudoexfoliation syndrome (PEX). Histopathological evaluation of conjunctival goblet cells in PEX patients might explain the influence on tear film stability.Methods In a prospective, cross-sectional study, 40 eyes of 40 patients with PEX (study group) had measurement of Schirmer test with anesthesia and break-up time prior to cataract surgery. At the end of an uneventful operation, a 1×1.5 mm sample of conjunctival tissue was obtained and light and electron microscopy were performed. Results were compared with a control group. Histology evaluation was masked. Primary outcome measures included Schirmer test with anesthesia, break-up time, goblet cell density and morphological character of conjunctiva and conjunctival goblet cells.Results Both Schirmer test and break-up time values were significantly lower (P=0.01 and P=0.001) in the PEX patients (mean 10.6 mm and 8.6 s respectively) than in the control group (13.4 mm and 12.3 s respectively). The number of goblet cells in patients with PEX compared with the control group showed no statistically significant difference (P=0.66). Use of trichrome stain revealed significant differences in the staining properties of goblet cells between patients with PEX and controls. On electron microscopy, typical pseudoexfoliation filaments were found in the connective tissue of conjunctiva of PEX patients. Remarkable changes of mucin pockets in the study group were also noticed; they had extremely irregular distribution, various forms of size and appearance and even complete collapse.Conclusion Pseudoexfoliation seems to alter basic features of goblet cell morphology, thus affecting tear film stability. Further studies are necessary to determine the exact mechanism.  相似文献   

6.
Effect of laser in situ keratomileusis on tear stability   总被引:46,自引:0,他引:46  
Yu EY  Leung A  Rao S  Lam DS 《Ophthalmology》2000,107(12):294-2135
OBJECTIVE: Patients frequently experience dry eye symptoms after laser in situ keratomileusis (LASIK). The mechanisms that lead to these changes are not well understood. The purpose of this study was to investigate the effect of LASIK on tear function. DESIGN: Prospective, comparative, nonrandomized interventional trial. PARTICIPANTS: Fifty-eight consecutive patients (96 eyes) who underwent myopic LASIK treatment. METHODS: The prospective study involved 58 consecutive patients (96 eyes) who underwent sequential or bilateral LASIK for the correction of myopia. Dry eye symptoms, standardized Schirmer test values, basal tear secretion test, and tear break-up time were measured before surgery and 1 day, 1 week, and 1 month after surgery. MAIN OUTCOME MEASURES: Schirmer test value, basal tear secretion value, and tear break-up time. RESULTS: Before surgery, 15.6% of patients (15/96) had dry eye symptoms. After surgery, 94.8% of patients (91/96), 85.4% of patients (82/96), and 59.4% of patients (57/96) experienced dry eye symptoms at 1 day, 1 week, and 1 month, respectively. Schirmer test value (13.32 +/- 10. 67 mm) increased at 1 day (14.48 +/- 10.57 mm; P = 0.25) and subsequently decreased at 1 week (11.18 +/- 9.81 mm; P = 0.05) and at 1 month (10.83 +/- 10.02 mm; P = 0.03). Basal tear secretion test value (8.49 +/- 8.48 mm) decreased at 1 day (6.80 +/- 6.48 mm; P = 0.05), at 1 week (5.97 +/- 6.88 mm; P = 0.005), and at 1 month (5.89 +/- 6.24 mm; P = 0.007). Tear break-up time (5.32 +/- 2.35 seconds) decreased 1 day (4.14 +/- 1.90 seconds; P < 0.001) and 1 week (4.49 +/- 1.70 seconds; P = 0.004) after surgery and recovered by 1 month after surgery (5.09 +/- 3.03 seconds; P = 0.52). Poor preoperative tear functions with a Schirmer test value less than 10 mm was a significant risk factor (72% vs. 46%; relative risk, 1.58 [1.10-2.26]) for experiencing dry eye symptoms at 1 month after surgery. CONCLUSIONS: Dry eye symptoms are common after myopic LASIK surgery. Laser in situ keratomileusis significantly altered the tear break-up time, Schirmer test values, and basal tear secretion. Patients with preexisting tear flow abnormality as demonstrated by Schirmer test values less than 10 mm are especially at risk of experiencing dry eye symptoms.  相似文献   

7.
目的:观察翼状胬肉切除联合带自体角膜缘干细胞的结膜移植治疗复发性翼状胬肉的临床疗效。 方法:复发性翼状胬肉患者84例,随机分为两组,研究组(43例43眼)行翼状胬肉切除联合带自体角膜缘干细胞的结膜移植术;对照组(41例41眼)行翼状胬肉切除联合自体结膜移植术。术后随访12mo,观察角膜上皮愈合时间、术后1,3 mo行泪膜破裂时间( BUT)、泪液分泌试验( S玉t试验)、角膜荧光染色检查( FL)、复发率,评价其临床疗效。 结果:研究组比对照组术后角膜上皮愈合时间短、复发率低(P〈0.05),但在术后1mo及3mo的BUT,S玉t试验,FL方面并无优越性(P〉0.05)。 结论:翼状胬肉切除联合带自体角膜缘干细胞的结膜移植是治疗复发性翼状胬肉的一种方便、安全、有效的方法。  相似文献   

8.
戴静  李大鹏  邰春平 《实用防盲技术》2013,8(3):122-124,119
目的探讨两种不同手术方式治疗翼状胬肉对泪液功能的影响及影响因素。方法选取翼状胬肉患者40例(40只眼)随机分成两组:A组20个病人(20只眼)翼状胬肉切除联合冻干羊膜移植术;B组20个病人(20只眼)翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术。术前,术后1mo,术后3mo行泪膜破裂时间(BUT)、泪液分泌试验(SchirmerI)、角膜荧光素染色(CSF),评价翼状胬肉及翼状胬肉切除术后泪膜功能变化对患者生活质量的影响。结果两组病人术后1moBUT缩短,角膜荧光素染色增多,差异有统计学意义(p<0.05),而术后SchirmerI与术前相比无统计学意义,两组术后3moBUT,SchirmerI,CFS与术前相比无统计学意义,翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术组术后早期泪膜稳定性优于翼状胬肉切除联合冻干羊膜移植术,差异具有统计学意义(p<0.05)。结论翼状胬肉切除术早期对泪膜功能有影响。翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术早期对泪膜的影响小于翼状胬肉切除联合冻干羊膜移植术。  相似文献   

9.
目的:探讨翼状胬肉切除联合游离结膜瓣移植术治疗原发性翼状胬肉的疗效及对泪膜功能的影响。方法:选择2018-01/2019-10我院收治的120例126眼原发性翼状胬肉患者作为研究对象,按照随机数字表法分为2组,结膜移植组62例64眼行翼状胬肉切除联合游离结膜瓣移植术治疗,羊膜移植组58例62眼行翼状胬肉切除联合羊膜移植治疗。测定术前,术后3、6mo时泪液分泌长度(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)评分、非侵入性首次泪膜破裂时间(NIBUT)、泪河高度(TMH)、结膜杯状细胞数量,采用眼表疾病指数(OSDI)评估患者生活质量,于术后6mo时评估治疗效果及复发情况。结果:结膜移植组及羊膜移植组患者角膜上皮平均修复时间、症状持续时间比较均无差异(P>0.05)。术后6mo结膜移植组患者BUT(11.11±2.77s vs 10.01±2.41s)、NIBUT(10.01±1.52s vs 9.52±0.98s)高于羊膜移植组(P<0.05),FL评分(0.44±0.10分vs 0.50±0.11分)低于羊膜移植组(P<0.05)。术后两组患者结膜杯状细胞数量均明显增加(P<0.05),术后3、6mo时结膜移植组患者结膜杯状细胞数量多于羊膜移植组(311.41±58.45/mm2vs 285.46±68.96/mm2,342.41±66.89/mm2vs 314.41±70.12/mm2,均P<0.05)。术后两组患者OSDI评分均显著降低(P<0.05),结膜移植组、羊膜移植组患者OSDI评分组间无差异(P>0.05)。两组患者总体疗效无差异(P>0.05);结膜移植组及羊膜移植组患者复发率分别为6.3%、6.5%,组间无差异(P>0.05)。结论:翼状胬肉切除联合自体结膜瓣移植在术后恢复及预防翼状胬肉复发方面与羊膜移植相当,对患者泪膜功能稳定性有更好的改善效果。  相似文献   

10.
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