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1.
Smart PLUG泪小管栓子对干眼症治疗的初步评价   总被引:1,自引:0,他引:1  
目的评价Smart PLUG泪小管栓子在干眼症治疗中的效果。方法 13例水液性泪液不足型(aque- ous tear deficiency,ATD)干眼症患者,其中Sjogren’s syndrome(SS)4例(8只眼),非Sjogren's syndrome9例(18只眼),应用Smart PLUG泪小管栓子治疗,在治疗前及治疗后1d、10 d、1m、3m分别对视力、干眼症状、泪河线、泪膜破裂时间(BUT)、Schirmer I a实验、荧光素染色(Fl)、每日需用人工泪液次数及治疗后可能出现的副反应进行检查并记录。结果应用Smart PLUG泪小管栓子治疗干眼后不同时间两组患者的干眼症状均有不同程度改善,每日需用人工泪液次数明显减少,最佳矫正视力不同程度提高,泪河线增加;BUT延长、基础泪液分泌增加、荧光素染色评分下降,与治疗前比较差异均具有显著性(P<0.05)。治疗期间未观察到副反应发生。结论Smart PLUG泪小管栓子可用于干眼的治疗,是治疗干眼症简便、安全的方法。  相似文献   

2.
目的:了解Sjgren综合征(Sjgren syndrome,SS)患者眼部临床特征,并评价Schirmer试验、泪膜破碎时间(BUT)和角结膜染色在确定SS中的临床意义。方法:选择初次确诊的原发性SS患者62例,依次进行外眼以及裂隙灯活体显微镜眼前节检查、SchirmerⅠ试验、BUT、荧光素角膜染色、丽丝胺绿结膜染色,并选择62例正常人作为对照,进行相同的检查。结果:取SS患者左眼右眼数据分别进行分析,各项检查数值左右眼无显著性差异。取SS组与对照组右眼数据进行分析,以Schirmer值≤5mm/5min为标准,68%SS患者表现出泪液分泌功能障碍,以BUT≤5s作为标准,84%SS患者具有泪膜不稳定的表现,以角结膜染色评分数值大于4分为标准,87%SS患者明确具有干眼病的眼表损伤体征,3项检查特异性依次为83%、87%和92%。结论:SS患者干眼病检查表现出明显异常,在诊断意义上角结膜染色评分大于BUT检查,BUT检查进而大于Schirmer试验。  相似文献   

3.
目的:了解Sj(o)gren综合征(Sj(o)gren syndrome,SS)患者眼部临床特征,并评价Schirmer试验、泪膜破碎时间(BUT)和角结膜染色在确定SS中的临床意义.方法:选择初次确诊的原发性SS患者62例,依次进行外眼以及裂隙灯活体显微镜眼前节检查、Schirmer Ⅰ试验、BUT、荧光素角膜染色、丽丝胺绿结膜染色,并选择62例正常人作为对照,进行相同的检查.结果:取SS患者左眼右眼数据分别进行分析,各项检查数值左右眼无显著性差异.取SS组与对照组右眼数据进行分析,以Schirmer值≤5mm/5min为标准,68%SS患者表现出泪液分泌功能障碍,以BUT≤5s作为标准,84%SS患者具有泪膜不稳定的表现,以角结膜染色评分数值大于4分为标准,87%SS患者明确具有干眼病的眼表损伤体征,3项检查特异性依次为83%、87%和92%.结论:SS患者干眼病检查表现出明显异常,在诊断意义上角结膜染色评分大于BUT检查,BUT检查进而大于Schirmer试验.  相似文献   

4.
干眼是常见的眼表疾病,水液缺乏性干眼是其中常见的临床亚型。水液缺乏性干眼分为Sj gren′s综合征(Sj gren′s syndrome,SS)和非SS水液缺乏性(non Sj gren′saqueoustear deficiency,NSTD)干眼两种类型[1]。研究发现干眼患者的角膜知觉发生明显改变[2,3],表明其神经的功能发生了改变,但目前对于干眼患者角膜神经是否发生形态学改变的研究不多,而且研究结果不一致[4,5]。为此,我们应用共焦显微镜技术对11例SS和27例NSTD患者的角膜神经进行研究,并与35例正常人角膜进行了对照,现将结果报道如下。一、对象和方法1.研究对象:38例(38只眼…  相似文献   

5.
目的:观察人工泪液治疗儿童干眼症的疗效及安全性.方法:对58例116眼经泪膜破裂时间(tear break-up time,BUT)、泪液分泌试验(Schirmer Ⅰ test,SⅠt)、泪河高度、角膜荧光染色、睑板腺功能检查方法确诊为干眼症的儿童患者进行人工泪液治疗,疗程为1 mo,复查时再次行上述检查,对各观察指标进行统计分析.结果:儿童于眼症患者58例116眼治疗前BUT为6.03±1.19s,SⅠt为7.67±2.32mm/5min,泪河高度为0.20±0.02mm,角膜荧光染色为1.02±0.13分,睑板腺功能评分为2.45 ±0.86分.其中31例62眼为脂质缺乏型干眼、20例40眼为水液缺乏型干眼、7例14眼为其他类型.根据其分型,给予相应的人工泪液治疗,治疗1mo后患者的临床症状明显改善,BUT为13.72±1.83s,SIt为12.38±3.64mm/5min,泪河高度为0.36±0.08mm,角膜荧光染色为0.03±0.24分,睑板腺功能评分为1.57±0.93分.各观察指标与治疗前相比,差异具有统计学意义(P<0.05).所有患者在治疗期间均未出现任何不良反应.结论:利用人工泪液治疗儿童干眼是安全、有效的.  相似文献   

6.
干眼是常见的眼表疾病,水液缺乏性干眼是其中常见的临床亚型.水液缺乏性干眼分为Sj(o)gren′s 综合征(Sj(o)gren′s syndrome,SS)和非SS水液缺乏性(non-Sj(o)gren′s aqueous tear deficiency,NSTD)干眼两种类型[1].研究发现干眼患者的角膜知觉发生明显改变[2,3],表明其神经的功能发生了改变,但目前对于干眼患者角膜神经是否发生形态学改变的研究不多,而且研究结果不一致[4,5].为此,我们应用共焦显微镜技术对11例SS和27例NSTD患者的角膜神经进行研究,并与35例正常人角膜进行了对照,现将结果报道如下.  相似文献   

7.
儿童干眼的初步研究   总被引:5,自引:0,他引:5  
骆非  邹留河 《眼科》2006,15(6):411-414
目的探讨儿童干眼是否存在及有何临床特点。设计前瞻性病例观察系列。研究对象38例(76眼)可疑儿童干眼患者,38例(76眼)正常儿童。方法对符合成年人干眼诊断标准的38例(76眼)儿童作为可疑干眼的观察组,取年龄与之匹配的正常儿童38例(76眼)作为对照组分别做基础泪液分泌试验(Schirmer)、泪膜破裂时间检查(BUT)、角结膜荧光素(FL)染色检查,对观察组行药物治疗并追踪观察6个月,再行以上三项检查。对可疑儿童干眼患者的症状、病因进行分析。主要指标症状, Schirmer,BUT,FL染色检查。结果38例可疑儿童干眼中瞬目次数增加21例(55.26%),干涩15例(39.47%),畏光14例(36.84%),眼红14例(36.84%)。观察组比对照组Schirmer和BUT均有显著性降低(P均=0.0000)。观察组和对照组Schirmer和BUT左右眼明显相关。观察组和对照组Schirmer和BUT两种检查无相关性。观察组药物治疗6个月前后Schirmer比较差异无统计学意义(P=0.368),BUT和FL检查有显著性改善(P=0.049,P=O.001)。结论儿童干眼确实存在,症状中以瞬目次数增加为最多,儿童干眼并非一时的主观症状,患儿可能存在较长时间(至少>6个月)的影响泪液分泌的病理状态。  相似文献   

8.
目的:在干眼综合征患者进行治疗的8年观察期中,评估临床病程中的主观症状、泪液功能因素和眼表面形态。方法:对眼部不舒适的97例患者(78例女性和19例男性),根据他们的典型症状和泪膜破裂时间缩短少于10s,临床诊断为干眼综合征。继续检查发现9例患者有水液层不足,32例患者有睑板腺功能障碍,30例患者有水液层不足合并睑板腺功能障碍,12例患者有水液层不足伴有Sjogren综合征,14例患者有水液层不足、睑板腺功能障碍伴有sjogren综合征。初次诊断后对患者进行了12—94个月(平均随访时间为40个月)的随访评估。主要结果测定:根据干眼泪膜破裂时间划分的不同小组在1—8年(平均3.3年)的随访后,将不加表面麻醉剂的Schirmer试验(Schirmer1)、荧光素和孟加拉玫瑰红染色、印记细胞学和主观干眼综合征状及泪液替代剂的使用情况与基础水平进行比较。结果:水液层功能不全合并sjogren综合征,以及水液层不足、睑板腺功能障碍合并Sjogren综合征与其他干眼综合征组比,在基础水平上泪膜功能和眼表面测试结果表示出更明显的病理学异常和更严重的主观症状。在泪液替代剂的使用频率上未观察到任何区别。在随访时,将泪膜破裂时间、Schirmer Ⅰ试验结果和改善的角膜荧光素染色情况与基础数值进行比较,而孟加拉玫瑰红染色和结膜表面的印记细胞学结果基本保持不变,主观症状和人工泪液的使用频率减少。结论:在长达8年的观察中,干眼综合征在适当的治疗后可得到改善或稳定。尽管没有患者得到彻底治愈,但主诉和人工泪液的使用频率都减少了。  相似文献   

9.
田甜  杨亚梦  朱炎华 《国际眼科杂志》2014,14(11):2098-2100
目的:分析干燥综合征( Sj?gren's syndrome,SS)患者干眼的临床特点。
  方法:回顾性分析2011-07/2014-06我院风湿免疫科SS患者136例272眼的干眼诊断性检查数据。
  结果:在136例患者中:(1)干眼症状中最常见的症状是干燥感,有88例,34例有两种以上的干眼症状;(2)睑缘情况:232眼发现睑缘变化;(3)泪河高度检测:244眼<0.3mm,平均值为0.19±0.11mm;(4)泪膜破裂时间(BUT)检查:206眼BUT≤5s,40眼5s10s,平均值为3.5±1.6s;(5)SchiemerI试验(SIt):200眼SIt≤5mm/5min,72眼5  结论:SS 干眼患者可见干燥感等干眼的常见症状,且BUT缩短、SIt减少、CF染色阳性,同时泪河高度降低、睑缘变化、睑板腺功能障碍,应密切关注SS患者中干眼的诊断和治疗。  相似文献   

10.
王琦  田甜  朱炎华 《国际眼科杂志》2014,14(11):2088-2090
目的:探讨睑板腺功能障碍( meibomian gland dysfunction, MGD)患者的诊疗方法,为临床治疗提供依据。
  方法:回顾性分析2012-07/2014-06在长江大学附属第一医院眼科门诊诊治的MGD患者96例192眼,裂隙灯显微镜下进行睑缘形态和功能的检查、泪膜破裂时间( BUT)、泪液分泌试验( SIt)检查,并进行清洁睑缘、睑板腺按摩、挤压睑板、人工泪液及抗生素和激素等综合治疗。结果:睑缘、睑脂排出情况平均评分分别为3.02±0.78,1.90±0 .76。所有患者BUT均异常,平均为4.3±1.9 s;84眼SIt正常,32眼5mm/5min  结论:MGD患者可引起干眼常见症状,通过睑板腺裂隙灯检查、BUT及SIt检查,可对患者进行及时、准确的诊断和积极治疗。  相似文献   

11.
准分子激光原位角膜磨镶术后泪膜的早期改变   总被引:49,自引:0,他引:49  
Yang B  Wang Z  Wu J  Huang G  Xu Z 《中华眼科杂志》2002,38(2):76-80
目的 探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)术后泪膜的早期改变。方法 对74例(148只眼)近视患者行LASIK,观察术前,术后1d、1周、1个月、3个月的干眼症状,包括干涩感、异物感、烧灼感,以及荧光素试验、孟加拉玫瑰红染色、泪膜破裂时间(breakup time of tear film,BUT)和泪液分泌量结果,并对数据进行统计学分析。结果 术后1周干燥感较术前加重(P<0.0127),其他时间与术前比较差异均无显著间谍(P>0.0127);术后1d和1周烧灼感较术前加重(P<0.0127),术后1个月、3个月与术前比较差异无显著意义(P>0.0127);术后1d、1周和1个月异物感染较术前明显加重(P<0.0127),3个月接近术前水平(P>0.0127)。术后1d和1周角膜荧光素着色点较术前明显增多(P<0.0127),术后1个月和3个月与术前比较差异无显著意义(P>0.0127);术后1d和1周孟加拉玫瑰红着色点较术前明显增多,差异有显著意义(P<0.0127),术后1个月和3个月接近术前水平(P>0.0127);术后1周和3个月泪液分泌量较术前明显减少,差异有显著意义(P<0.05),术后1个月接近术前水平(P>0.05);术后1d、1周、1个月和3个月BUT均较术前缩短(P<0.05)。结论 LASIK对泪膜具有一定程度不良影响,发生机制与多种因素有关;临床应积极采取预防措施,以使LASIK术后干眼症的发生率和严重程度降至最低。  相似文献   

12.
PURPOSE: To reinvestigate tear evaporation rates in Sj?gren syndrome (SS) and non-Sj?gren (non-SS) dry eye patients with a recently reported ventilated chamber evaporimeter system. DESIGN: Prospective case-control study. METHODS: A ventilated chamber evaporimeter system was used to measure tear evaporation rates. A DR-1 camera (Kowa, Nagoya, Japan) was used for tear lipid layer interference image acquisition. The Yokoi severity grading system was used for DR-1 image evaluation. Twenty-four aqueous tear deficiency (ATD) eyes of 21 consecutive patients with SS were studied (SS ATD group). Twenty-one ATD eyes of 12 non-SS patients (non-SS ATD group) were examined as control subjects. RESULTS: Tear evaporation rates of the SS ATD group (5.9 +/- 3.5 [10(-7) g/cm(2) per second]) were significantly higher than those of the non-SS ATD group (2.9 +/- 1.8 [10(-7) g/cm(2) per second]; P = .0009). The severity grading of DR-1 tear interference images of the SS ATD group was significantly higher (P = .03), along with significantly worse meibomian gland expressibility and vital staining scores, compared with those of the non-SS ATD group. CONCLUSIONS: Tear evaporation rates were higher in eyes of the SS ATD group compared with the non-SS ATD group. Tear evaporation assessed in conjunction with tear lipid layer findings and meibomian gland expressibility provides an increased understanding in the differential diagnosis of dry eye states.  相似文献   

13.
Qiu X  Gong L  Lu Y  Jin H  Robitaille M 《Acta ophthalmologica》2012,90(5):e359-e366
Purpose: To determine the role of Fourier-domain optical coherence tomography (FD-OCT) in tear meniscus imaging and evaluate its diagnostic significance in Sj?gren syndrome (SS), non-Sj?gren's aqueous tear deficiency (ATD) and lipid tear deficiency (LTD) patients. Methods: Two hundred and thirty-six dry eye patients and 174 healthy controls were enrolled in this study. All subjects were grouped as follows: group A (ATD), group B (LTD), group C (SS) and group D (normal controls). All subjects underwent dry eye questionnaire, FD-OCT scanning, tear film break-up time (BUT), corneal fluorescence staining and Schirmer I test (SIT). Tear meniscus height (TMH), tear meniscus depth (TMD) and tear meniscus cross-sectional area (TMA) were measured using FD-OCT (RTVue-100). The area under the receiver operating characteristic curve and the cut-off point were determined using a logistic regression model. Results: Mean TMH, TMD, TMA, BUT and SIT of dry eye patients were significantly lower than those of the controls (p?相似文献   

14.
AIM: To test the short term efficacy and safety of an infrared warm compression device (IWCD, Eye Hot, Cept Co, Tokyo, Japan) as treatment for non-inflamed meibomian gland dysfunction (MGD). METHODS: 37 subjects with non-inflamed obstructive MGD, with and without aqueous tear deficiency (ATD) dry eye, participated in a prospective non-comparative interventional case series. Symptom scores, face scores, tear evaporation rates, fluorescein and rose bengal vital staining, tear break up time (BUT), Schirmer test, meibomian gland obstruction, and meibography were compared before and after 2 weeks of therapy. RESULTS: In a total of 37 cases, total subjective symptom scores and subjective face scores improved significantly, from 12.3 (SD 5.9) to 8.4 (6.1), and from 7.0 (1.7) to 5.3 (2.0) (both p <0.0001). The results for tear evaporation rates during forced blinking (p = 0.002), fluorescein staining (p = 0.03), rose bengal staining (p = 0.03), BUT (p <0.0001), and meibomian gland orifice obstruction score (p <0.0001) had also improved significantly at the end of the 2 week period of infrared thermotherapy. No complaints and/or complications of the IWCD were reported. CONCLUSION: The IWCD was effective and safe for the treatment of MGD. Improved tear stability associated with release of meibum is a possible mechanism of this treatment.  相似文献   

15.
PURPOSE: To assess the clinical efficacy of a newly developed disposable eyelid-warming device (Eye Warmer) for the treatment of meibomian gland dysfunction (MGD). METHODS: The Eye Warmer was applied for 5 minutes to 44 eyes of 22 patients who exhibited decreased tear break-up time (BUT) and dry-eye symptoms. Its efficacy was assessed on the basis of BUT and dry-eye symptoms in the short-term study. In the therapeutic study, the Eye Warmer was applied to 34 eyes of 17 MGD patients with decreased BUT and dry-eye symptoms for 5 minutes once a day for 2 weeks. The 16 eyes of 8 patients served as untreated controls. We examined tear film lipid layer interference patterns, BUT, meibomian gland secretion, and dry-eye symptoms in both groups before and after the treatment. RESULTS: BUT and dry-eye symptoms significantly improved after the treatment in both the short-term and the therapeutic study (P<.01). The incidence of normal tear lipid layer in the treated group was significantly higher after treatment (28 eyes [82.4%]) than before (19 eyes [55.9%]) (P=.036). The incidence of meibomian gland obstruction was significantly decreased after treatment (14 eyes [41.2%]) compared to before treatment (26 eyes [76.5%]) (P=.006). CONCLUSIONS: Warming the eyelids with the Eye Warmer improved the stability and uniformity of the tear lipid layer in MGD patients by melting the meibomian gland lipid. Our study demonstrates the usefulness of the Eye Warmer for the treatment of MGD.  相似文献   

16.
OBJECTIVE: We developed low-concentration homogenized castor oil eye drops for the treatment of patients with noninflamed obstructive meibomian gland dysfunction (MGD), a major cause of lipid-deficiency dry eye, and assessed the safety, stability, and efficacy of the eye drops. DESIGN: Randomized, double-masked, placebo-controlled crossover clinical trial. PARTICIPANTS: Forty eyes of 20 patients with noninflamed MGD. METHODS: After a preliminary study of eye drops containing castor oil, 2% castor oil and 5% polyoxyethylene castor oil (emulsifier) were mixed to formulate homogenized oil eye drops. The patients were assigned randomly to receive oil eye drops or placebo six times daily for 2 periods of 2 weeks each. MAIN OUTCOME MEASURES: At the end of each treatment period, we assessed symptoms, tear interference grade, tear evaporation, fluorescein and rose bengal scores, tear break-up time (BUT), and meibomian gland orifice obstruction. Safety and stability tests were also performed. RESULTS: Symptom scores, tear interference grade, tear evaporation test results, rose bengal scores, tear BUT, and orifice obstruction scores after the oil eye drop period showed significant improvement compared with the results after the placebo period. No complications attributable to the eye drops were observed. The oil eye drops were stable when stored at 4 degrees C. CONCLUSIONS: The results indicate that castor oil eye drops are effective and safe in the treatment of MGD. The possible mechanisms of this treatment are improvement of tear stability as a result of lipid spreading, ease of meibum expression, prevention of tear evaporation, and the lubricating effect of the oil eye drops.  相似文献   

17.
目的:通过对肝肾阴虚型干眼症患者采用“复明片”加减联合睑板腺疏通法临床治疗的疗效观察,说明中西医结合治疗肝肾阴虚型干眼症可以收到良好的效果。方法:对符合干眼症诊断标准的400例患者的性别、年龄、症状、临床表现进行详细记录并进行严格的中医辨证分型,并对辩证为“肝肾阴虚”型的干眼症患者90例随机分三组治疗:A组30例给予“复明片”加减联合睑板腺疏通法加人工泪液治疗;B组30例给予睑板腺疏通法加人工泪液治疗;C组30例给人工泪液治疗。三组患者的自觉症状、泪液分泌试验(SchirmerⅠtest,SⅠt)、泪膜破裂时间(tear break-up time,BUT)、角膜荧光素染色(fluorescein staining,FL)和角膜地形图的角膜表面规则指数(surface regularity index,SRI)和角膜表面不规则指数(surface asymmetry index,SAI)结果作为观察指标,对观察数据进行统计分析,每组治疗前后行配对资料的秩和检验;对三组的疗效行多个样本间两两比较的秩和检验。结果:A组观察指标改善情况及疗效明显优于B,C两组;B组的又优于C组;三组的有效率分别是90.0%,73.3%和53.3%;结论:对肝肾阴虚型干眼症,采用“复明片”加减联合睑板腺管疏通术和人工泪液的治疗方法可以取得良好的治疗效果。睑板腺功能障碍(MGD)直接相关或合并MGD是干眼症的病因之一;同时角膜地形图可以协助诊断和评价干眼症的严重程度和治疗效果。   相似文献   

18.
目的 探讨围绝经期妇女的干眼症状与干眼病诊断的相关性. 方法分析56例具有干眼症状的围绝经期妇女眼部检查的临床资料,观察主诉为干眼症状患者的干眼病确诊率及其关系.结果 56例以干眼症状为主要表现的围绝经期妇女,确诊水液缺乏型干眼17例(30.4%),蒸发过强型干眼12例(21.4%),混合型干眼8例(14.3%);不能诊断干眼病的19例(33.9%),最终诊断为围绝经期综合征. 结论围绝经期妇女干眼病确诊率较高(66.1%),但部分干眼症状可以只是围绝经期综合征的精神神经症状的一种表现,临床诊断干眼应慎重.  相似文献   

19.
The tear film lipid layer is the major barrier to evaporation from the ocular surface. A decrease in its thickness or functional integrity may cause evaporative dry eye (EDE). Obstructive meibomian gland dysfunction (MGD) is the most common cause of EDE and occurs as a primary disorder or secondary to acne rosacea, seborrheic or atopic dermatitis, and with cicatrizing conjunctival disorders, such as trachoma, erythema multiforme, and cicatricial pemphigoid. MGD may be an incidental finding in asymptomatic eyes, or it may be responsible for irritative lid symptoms in the absence of dry eye. MGD-dependent EDE is diagnosed on the basis of a defined degree of MGD in a symptomatic patient showing typical ocular surface damage in the absence of an aqueous tear deficiency. When MGD occurs in a background of aqueous tear deficiency (ATD), then an additional evaporative component may assumed, depending on the extent of meibomian obstruction. However, definitive criteria are not yet established. The clinical severity of dry eye is greatest when ATD and EDE occur together, particularly in Sjogren syndrome. A hypothesis is proposed to explain the steps leading to primary, simple MGD and subsequent EDE.  相似文献   

20.
高度近视准分子激光原位角膜磨镶术后干眼症临床分析   总被引:18,自引:0,他引:18  
目的了解高度近视患者行准分子激光原位角膜磨镶术(LASIK)术后干眼症状及相关指标的变化。方法84例(168只眼)高度近视患者行LASIK手术,分别观察术前、术后1周、1个月、2个月、3个月及6个月的干眼症状,包括干涩感、异物感等,并行角膜荧光素染色,记录泪液分泌量(SchirmerⅠ试验)和泪膜破裂时间(BUT),对数据进行统计学分析。结果术后1周至2个月干眼症状明显加重(p<0.01),直至3个月角膜荧光素染色仍较术前明显增加(p<0.05)。术后1周至3个月泪液分泌量较术前明显减少(p<0.01),术后1周至2个月BUT较术前明显缩短(p<0.01)。而术后1周有56眼(33.33%)达到干眼症诊断标准,术后一个月为61眼(40.39%),术后3个月恢复正常。结论高度近视LASIK术后发生干眼症为常见并发症,临床上应采取相应预防和治疗措施,降低干眼症发生率,减少其危害。  相似文献   

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