原发性翼状胬肉与干眼关系的临床观察

目的:探讨原发性翼状胬肉与干眼的关系。方法:选择2011-08/2012-08住院行手术治疗的原发性单眼翼状胬肉患者50例,行回顾性分析,以胬肉眼为观察组,对侧眼为对照组,比较两组患者的眼部症状评分、泪液分泌试验(SchirmerⅠtest,SⅠt)、泪膜破裂时间(tear break-uptime,BUT)、眼表荧光素染色(fluorescent,FL)干眼评分。结果:观察组与对照组的SⅠt比较无统计学差异(P>0.05),但观察组BUT明显低于对照组(P<0.05),眼部症状、FL干眼症评分相比,观察组明显高于对照组(P<0.05)。结论:原发性翼状胬肉患者胬肉眼可同时患有干眼,可伴有明显的眼部干涩、视力下降、异物感等干眼症状,眼表泪膜的稳定性下降,并伴有眼表上皮的损害,翼状胬肉与干眼可同时共存,关系密切,但二者之间是否存在因果关系尚不明确。     

改良酒精浸泡剥离法行翼状胬肉切除术的临床疗效评价

目的 评价应用改良酒精浸泡剥离法行翼状胬肉切除术的临床疗效.方法 选择103例(103眼)翼状胬肉患者为研究对象,分为对照组41例(41眼)和改良组62例(62眼).对照组患者行常规翼状胬肉切除加羊膜移植术;改良组患者先用体积分数20％酒精浸泡翼状胬肉头部,再行常规翼状胬肉切除加羊膜移植术.比较两组术后症状消失时间、上皮愈合时间、并发症和复发情况及其术前、术后泪膜破裂时间、角膜散光度数和总高阶像差.结果 改良组的症状消失时间、上皮愈合时间分别为(1.14±0.67)d、(4.12±1.31)d;对照组分别为(1.82±0.91)d、(5.54±1.82)d.改良组症状消失时间、上皮愈合时间明显短于对照组,差异均有统计学意义(t=4.428、4.582,均为P＜0.05).改良组术后泪膜破裂时间为(9.82±0.41)s,对照组为(8.86±0.28)s,差异有统计学意义(t=10.074,P=0.000).改良组术后角膜散光度数(-0.409±0.208)D明显低于对照组(-0.571±0.392)D,差异有统计学意义(t=2.728,P=0.008).总高阶像差明显低于对照组,差异有统计学意义(P =0.029).改良组复发率明显低于对照组(分别为4.84％、9.76％),差异有统计学意义(P＜0.05).两组术后并发症发生率比较差异无统计学意义(P＞0.05).结论 改良酒精浸泡剥离法行翼状胬肉切除术可有效改善眼部症状,提高临床疗效,安全性高,复发率低.     

角膜缘干细胞移行遮盖法切除翼状胬肉

目的 比较角膜缘干细胞移行遮盖法切除翼状胬肉和单纯翼状胬肉切除术对初发性翼状胬肉的疗效.方法 将167例(207只眼)初发性翼状胬肉患者随机分成A、B两组:A组81例(101只眼)行角膜缘干细胞移行遮盖法切除;B组86例(106只眼)行单纯翼状胬肉切除术.术后随访24个月,观察比较两组患者术眼不适症状持续时间、角膜上皮愈合时间以及翼状胬肉复发情况.结果 A组3例(3只眼)翼状胬肉复发,复发率为3.1%;B组19例(23只眼)翼状胬肉复发,复发率为23.5%,两组比较差异有统计学意义(P＜0.001);在术后1周、2周及1月时,两组不适症状眼数差异有统计学意义(P＜0.001);角膜上皮愈合时间比较,差异有统计学意义(P＜0.001).结论 角膜缘干细胞移行遮盖法切除翼状胬肉具有简便快捷,创伤小,修复快,术后患者自觉症状轻,复发率低等优点.     

眼科门诊干眼的流行病学调查及相关危险因素分析

目的 了解眼科门诊就诊者中干眼患病状况,并探讨干眼发病的相关危险因素.方法 收集2005年4月至6月、9月至11月眼科门诊就诊的650例30岁以上者作为研究对象,在获得知情同意后进行干眼问卷调查及泪膜破裂时间(break up time,BUT)试验,对其中干眼症状阳性及BUT<10 s者进行角膜荧光素染色、睑板腺功能检查、基础泪液分泌试验、虎红染色4项干眼的客观检查,对确诊的干眼患者按12配比的方法进行病例对照研究,分析其相关危险因素.结果 650例调查对象(年龄30～83岁,平均49.9岁)干眼总的患病率为20.6%,女性(26.2%)多于男性(15.0%,P＜0.001);干眼的患病率随年龄增长而增高,在60岁以上年龄组患病率高于60岁以下年龄组(P＜0.05),30岁年龄组患病率最低(11.1%),眼部不适症状中最多见的是干涩感182例(28.0%),其次为疲劳感158例(24.3%),最少见的症状为眼痛42例(6.5%);平均BUT为(9.50±2.86)s,男性(10.22±2.30)s高于女性(8.76±3.16)s,泪膜稳定性高于女性(t'＝6.641,P=0.000),BUT随年龄增长而缩短,60岁以下年龄组BUT高于60岁以上年龄组(P＜0.001);农民干眼的患病率高于其他职业(P＜0.001).多因素条件Logistic回归分析显示以下因素是与干眼相关的危险因素:滴眼液(P＜0.001,OR 1.890,CI 1.338～2.668)、糖尿病(P＜0.001,OR 3.144,CI 1.788～5.529)、翼状胬肉(P＜0.001,OR 3.982,CI 1.982～7.783)、使用视频终端(P＜0.05,OR 1.737,CI 1.192～2.532),而服用阿斯匹林、多种维生素,甲状腺疾病、高血压、过敏性疾病、青光眼、眼部手术及屈光不正病史与干眼无相关性.结论 干眼与年龄、性别及职业相关,糖尿病、翼状胬肉、长期使用滴眼液和视频终端这些因素可能是新疆干眼相关的危险因素.     

丝裂霉素C用于翼状胬肉自体角膜缘干细胞移植的临床分析

目的 评价丝裂霉素C (MMC)对翼状胬肉自体角膜缘干细胞移植术疗效的影响.方法 将241例(317只眼)患者随机分为两组,MMC组183只眼,其中原发性胬肉123只眼,复发性胬肉60只眼;对照组134只眼,其中原发性胬肉94只眼,复发性胬肉40只眼.两组均常规行翼状胬肉切除联合自体角膜缘干细胞移植,MMC组术中使用0.02％MMC棉片4 min.对照组不使用任何药物.定期随访12～24个月,观察胬肉复发情况及术后并发症.结果 原发性胬肉组及复发性胬肉组,胬肉复发率MMC组均低于对照组,眼部刺激症状、角膜上皮修复时间及移植片愈合时间两组差异均无统计学意义(P＞0.05).结论 翼状胬肉切除并自体角膜缘干细胞移植术中应用0.02％ MMC可起到协同作用,能进一步降低术后复发率,对复发性胬肉更具有意义.无毒副反应产生.     

羊膜移植与角膜缘干细胞移植治疗复发性翼状胬肉疗效对比

目的 比较角膜缘干细胞移植和羊膜移植对复发性翼状胬肉的疗效.方法 将81例(94只眼)复发性翼状胬肉患者随机分成A、B组;A组45例(48只眼)行翼状胬肉切除联合自体角膜缘干细胞移植术;B组36例(46只眼)行翼状胬肉切除术联合羊膜移植术.随诊1.5年,观察两组患者的角膜修复时间、复发率及并发症.结果 A组3例患者(3只眼)翼状胬肉复发,复发率为6.3％;B组7例患者(10只眼)翼状胬肉复发,复发率为21.7％,两组比较,差异有统计学意义(x2=4.729,P=0.03).结论 角膜缘干细胞移植术与羊膜移植术相比能明显的降低复发率,减少角膜修复时间,是治疗复发性翼状胬肉的好方法.     

翼状胬肉术中应用丝裂霉素与羊膜移植的效果比较

目的 观察翼状胬肉术中应用丝裂霉素与新鲜羊膜移植的效果.方法 将66例(72眼)原发性翼状胬肉随机分为两组,丝裂霉素C组33例(36眼),羊膜移植组33例(36眼).结果 丝裂霉素C组术后复发2眼(复发率为5.56％);羊膜移植组术后复发1眼(复发率为2.50％).结论 翼状胬肉术中应用丝裂霉素C与移植羊膜均能有效降低胬肉术后的复发率.两组比较差异无统计学意义(P＞0.05).     

两种手术方式治疗翼状胬肉术后泪膜稳定性观察

目的 观察两种不同手术方式治疗翼状胬肉对术后泪膜质和量的影响.方法 选取翼状胬肉患者90例90只眼,随机分为翼状胬肉切除联合羊膜移植组,翼状胬肉切除联合角膜缘干细胞移植组.术后2天,1周,1个月、3个月行泪液分泌(Schirmerl)试验、泪膜破裂时间(breakuptime,BUT),泪液羊齿状物试验(mucusfemtest,MFT),印迹细胞学检查.结果 术后两组泪液分泌量,羊齿状结晶物检查差异无统计学意义.翼状胬肉切除联合角膜缘干细胞移植组术后早期泪膜稳定性优于翼状胬肉切除联合羊膜移植组,差异具有统计学意义(P＜0.05).印迹细胞学检查表明术后两组上皮细胞形态及杯状细胞数量,鳞状上皮化生程度无明显差异.结论 翼状胬肉切除联合角膜缘干细胞移植手术治疗翼状胬肉较翼状胬肉切除羊膜移植术后早期可保持良好的泪膜稳定性,患者干眼症状轻.适合术前有干眼症状的翼状胬肉患者.     

人工泪液与重组人表皮生长因子衍生物眼液对翼状胬肉术后干眼疗效观察

目的 探讨人工泪液联合重组表皮生长因子衍生物滴眼液治疗翼状胬肉术后干眼的疗效.方法 选择翼状胬肉术后有干眼症状的患者82例(96只眼),随机分为治疗组和对照组两组,每组41例(48只眼),治疗组给予人工泪液(泪然)和重组表皮生长因子衍生物(金因舒)治疗,对照组单用人工泪液,裂隙灯下观察,记录用药前及用药后2周、4周泪膜破裂时间(BUT),泪液分泌实验(schimer-1),角膜荧光素染色(FL)以及干眼症状的改善程度.结果 治疗前,治疗组与对照组Schirmer-1、BUT、FL差异无统计学意义(P>0.05);用药后2周、4周,治疗组schimer-1、BUT、FL以及临床症状的改善与对照组比较,差异有统计学意义(P<0.01).结论 人工泪液联合重组表皮生长因子衍生物滴眼液治疗翼状胬肉术后干眼疗效优于单用人工泪液,效果显著.     

自体角膜缘干细胞移植治疗翼状胬肉疗效分析

0引言翼状胬肉是一种常见的眼表疾病,轻者影响美容,引起眼部刺激症状;较大的胬肉因引起屈光异常或遮盖瞳孔而导致视力下降。严重的复发性翼状胬肉可引起睑球粘连、结膜穹隆部变窄、眼球运动受限等并发症[1,2]。为观察翼状胬肉术后复发问题,我们分别采用自体角膜缘干细胞移植治疗翼状胬肉患者,现报告如下。1临床资料2004-07/2008-06对门诊和住院翼状胬肉患者32例(36眼)在显微镜下进行了手术,其中初发性翼状胬肉22例(26眼),复发性10例(10眼)。男12例(13眼),女20例(23眼)。年龄34～71(平均46.2)岁。所有行翼状胬肉切除并自体角膜缘干细胞移植术。术前常规使用复方硫酸新霉素滴     

Prevalence of Dry Eye Disease in Mongolians at High Altitude in China: The Henan Eye Study

Purpose: To estimate the prevalence of dry eye disease, analyze the associations between dry eye symptoms and signs, and identify the risk factors in an elderly Mongolian population at high altitude in China.

Methods: A population-based survey was conducted in 2006. A total of 2,486 Mongolians age 40 and older were selected. Symptoms of dry eye were assessed using a 6-item validated questionnaire. Dry eye disease was defined if participants reported one or more symptoms often or all the time. Positive signs included a tear-film breakup time of ≤10 seconds, a Schirmer test score of ≤ 5mm, or a fluorescein staining score ≥ 1 in one or both eyes. Presence of dry eye symptoms and positive signs were analyzed. Correlations between symptoms and signs, and risk factors were evaluated in a multivariate model.

Results: Of the 1,816 participants, 50.1% (95% confidence interval, 47.8–52.4) were symptomatic. Tear-film breakup time of ≤ 10 seconds was 37.7% (95% confidence interval, 35.5–39.9). A Schirmer test score of ≤ 5mm was 19.9% (95% confidence interval, 18.4–22.1). Fluorescein staining score ≥ 1 was 6.0% (95% confidence interval, 4.9–7.1). The correlation between dry eye symptoms and positive signs (tear-film breakup time of ≤ 10 seconds[r = 0.414, P < 0.001], Schirmer test score of ≤ 5mm [r = 0.164, P = 0.001], and fluorescein staining score ≥1 [r = 0.361, P < 0.001]) were statistically significant. Independent risk factors included increased age, age-related cataract and pterygium.

Conclusion: This study demonstrates a high prevalence rate of dry eye disease in a Mongolian population. Dry eye signs were significantly associated with dry eye symptoms.     

Prevalence of dry eye in Bangkok, Thailand

PURPOSE: To estimate the prevalence of dry eye in the adult population of Bangkok, Thailand. METHODS: Five hundred fifty volunteers 40 years of age or more who presented to the Ramathibodi Hospital for annual eye examinations were enrolled. Interviewers administered a dry eye symptoms questionnaire. Slit-lamp examination and objective dry eye assessment consisting of tear film breakup time (TBUT), fluorescein corneal staining, Schirmer tests, and meibomian gland evaluation were performed. Outcome measures included frequency of symptoms and positive dry eye tests. RESULTS: Thirty-four percent reported significant symptoms, which were defined as having one or more symptoms often or all of the time (95% confidence interval, 28.1-40.6). Approximately one half had meibomian gland disease (MGD) or pingueculum/pterygium (46.2 and 53.8%, respectively). Individuals with significant symptoms tended to be women (83.4%, P = 0.024), had MGD (63.6%, P = 0.006), had current artificial tear use (33.2%, P = 0.024), and had positive TBUT (80.7%, P = 0.000) and fluorescein staining (16.6%, P = 0.013.) The presence of pingueculum/pterygium and MGD were significantly associated with positive dry eye tests. CONCLUSION: This is the first report of prevalence of dry eye inclusive of signs and symptoms in an elderly Thai population. The prevalence of disease diagnosed on the basis of symptoms and dry eye tests was approximately 2 to 3 times higher than reported in whites. Women were more likely to report symptoms. Positive associations with dry eye tests were found in subjects with pingueculum/pterygium and MGD.     

昌都市14岁以下儿童干眼症患病情况调查及危险因素分析

目的：探讨昌都市14岁以下儿童干眼症患病情况调查及危险因素。

方法：横断面研究,于2019-08对昌都市14岁以下中小学生进行流行病学调查,采用自制问卷调查,分析该地区14岁以下儿童干眼症患病情况调查及危险因素。

结果：本研究理论受检儿童2 648例,调查过程中共2 389例儿童接受调查,总体受调查率为90.22%,实际受检者中有干眼症状413例(17.29%),确诊干眼症331例,干眼症患病率为13.86%。单因素分析显示,干眼症儿童和非干眼症儿童的年龄、性别、眼部手术史、眼部外伤史、喜食蔬菜水果、过敏性结膜炎、倒睫、屈光不正、沙眼、睑缘炎、阅读书写姿势、隐形眼镜、看电脑或手机时间、被动吸烟、抗生素滴眼液的资料有差异(P<0.05)。多因素Logistic分析显示,年龄、过敏性结膜炎、睑腺炎、屈光不正、被动吸烟是昌都市儿童干眼症发生的危险因素(P<0.05)。

结论：昌都市14岁以下儿童干眼症发病率较高,年龄、过敏性结膜炎、睑腺炎、屈光不正、被动吸烟是昌都市儿童干眼症发生的危险因素。     

翼状胬肉切除联合不同移植术式后干眼症的临床观察

目的：探讨翼状胬肉切除联合移植的不同手术方法术后干眼症的情况。
　　方法：选取翼状胬肉患者78例81眼,随机分成3组, A组：行翼状胬肉切除联合大块自体球结膜瓣移植术;B组：行翼状胬肉切除联合小块自体球结膜瓣移植术;C组：行翼状胬肉切除术联合小块带自体角膜缘干细胞结膜瓣移植术。观察三组患者术后角膜上皮修复时间,术前和术后1,3mo检查泪膜破裂时间(BUT)以及眼表疾病指数(ocular surface disease index,OSDI)问卷调查,来评价翼状胬肉及胬肉切除术后引起干眼症的情况。
　　结果：BUT：术后15d,A组较B,C组明显缩短(P<0.05),术后1mo,A组与B,C组间无明显差异(P>0.05),但术后1mo时并发干眼症阳性率均较B,C组高(P<0.05);B,C 组间术后并发干眼症阳性率比较无显著差异( P>0.05),但C组有阳性率低的趋势。上皮修复时间A组较B,C组长(P<0.05);B,C组间无显著差异(P>0.05),但C组有时间更短的趋势。
　　结论：胬肉切除联合小块自体角膜缘干细胞移植术术后角膜上皮修复更快,引起干眼症的几率最小,术式最佳。     

Evaluation of dry eye signs and symptoms in patients with systemic sclerosis

Background

One of the most frequent ocular features of systemic sclerosis (SSc) is dry eye disease (DED), which has been identified to occur in 37–79% of patients. Although several studies have found weak or no correlations between symptoms and signs of dry eye, symptoms are often the motivation for seeking eye care, and are therefore a critical outcome measure when assessing treatment effect. The aim of this study is to evaluate the impact of symptoms of dry eye on vision-related quality of life in patients with systemic sclerosis, and to investigate the relation between clinical tests and symptoms of dry eye in these patients.

Methods

In this cross-sectional study, 45 consecutive patients with SSc were enrolled. For evaluation of the symptoms the “Ocular Surface Disease Index (OSDI)” questionnaire was applied to all patients. After that, all individuals were submitted to a full ophthalmic examination, including the following tests: tear break-up time, Schirmer I, rose bengal staining. Patients were then grouped into dry eye and non-dry eye groups with regard to the diagnosis of dry eye. Mann–Whitney test was used to compare continuous variables, whereas the Fisher exact test was used to compare categorical data between groups. Spearman’s correlation test was used to analyze the correlations between clinical tests and OSDI scores. P values?<0.05 were considered significant.

Results

Dry eye disease was diagnosed in 22 patients (48.9%). Other ocular surface abnormalities found were: blepharitis (40% of the patients), pterygium (15.6%), pinguecula (82.2%), and superficial punctate keratitis (26.7%). Among the 45 patients, 29 patients (64.4%) had symptoms of ocular surface disease. The mean OSDI score was 26.8?±?25.8 (SD). There were no statistically significant differences in OSDI scores between DED and non-DED patients. No substantive correlations were found between OSDI scores and TBUT, Schirmer I, or rose bengal staining score, and none of the observed correlations reached statistical significance.

Conclusion

Symptoms of dry eye have a moderate impact on vision-related quality of life in patients with systemic sclerosis and do not correlate well with clinical findings.     

Fixation and its role in the causation, laterality and location of pterygium: a study in amblyopes and non-amblyopes

Aim

To evaluate the role of fixation in causing pterygium and determining its laterality and location.

Methods

This is a prospective, observational, case–control study. Cases were defined as patients with primary pterygium who had unilateral amblyopia with eccentric fixation. Controls were age-matched patients with primary pterygium, but without amblyopia and eccentric fixation. All patients underwent complete ocular, orthoptic, and systemic examination and a detailed risk-factor assessment (latitude of residence, exposure to sunlight, sand, and a high-reflectance environment). The role of fixation in the causation, laterality and location of pterygium was evaluated. Fisher''s exact test, the unpaired t-test, and odds ratio (OR) were carried out to determine the significance of the observations.

Results

The mean age of subjects was 47.1±5.25 years in cases (n=107) and 48.2±4.75 years in controls (n=310; P=0.78). As far as known risk factors were concerned, both groups were evenly matched. Among the cases, 88 (82.2%) patients demonstrated suppression of the amblyopic eye and 19 (17.8%) patients had abnormal retinal correspondence (ARC). Patients with suppression had a unilateral pterygium in the better (fixating) eye, whereas those with ARC had bilateral pterygia. Among the controls, 192 (61.9%) eyes had bilateral pterygia and 118 (38.1%) eyes had unilateral pterygium. In controls, the dominant eye had a higher prevalence of pterygium. All patients in both groups had a nasal pterygium. Pterygium and fixation were strongly associated (P=0.007; Fisher''s exact test; OR −15.98; P=0.008).

Conclusion

Fixation appears to have an important role in causing pterygium and determining its location and laterality.     

手术切除联合自体血清滴眼液治疗翼状胬肉的疗效观察

目的:探讨手术切除联合100%浓度自体血清滴眼液治疗翼状胬肉的疗效.方法:选取2015-03/2016-03在钟祥市人民医院眼科住院确诊的120例120眼翼状胬肉患者,将其随机分为对照组和试验组.全部患者术后结膜囊内涂妥布霉素地塞米松眼膏加压包扎患眼,次日采用妥布霉素地塞米松滴眼液滴眼,6次/d,2滴/次;对照组加用聚乙烯醇滴眼液,6次/d,2滴/次;试验组加用100%浓度的自体血清滴眼液滴眼,6次/d,2滴/次.两组滴眼液每周递减2次,均治疗3 wk.术后3 mo进行手术疗效评定.结果:两组患者手术前的一般情况、眼部症状体征评分和泪液分泌试验的比较无统计学差异(P>0.05).手术后两组患者的眼部症状体征评分、角膜上皮和/或基质缺损面积及修复时间、泪液分泌试验的比较有统计学差异(P<0.05).对照组患者术后3 mo的复发率是6.7%;试验组是3.3%,两组间比较差异有统计学意义(P<0.05).结论:翼状胬肉切除联合带自体角膜缘干细胞结膜瓣移植术后辅助应用100%浓度的自体血清滴眼治疗胬肉术后创面的愈合、眼表的重建,取得了很好的疗效.     

云南省文山州40岁及以上壮族和苗族人群翼状胬肉患病率及其影响因素

目的:调查云南省文山州40岁及以上壮族和苗族人群的翼状胬肉患病率及其影响因素。方法:采用手持式裂隙灯和Keratograph-D眼表综合分析仪对云南省壮族和苗族目标人群进行流行病学调查,采用Logistic回归分析研究性别、年龄、职业、是否户外活动和民族等因素对翼状胬肉的影响。结果:于2019-03/11选取调查对象共1239人,确诊翼状胬肉437人,翼状胬肉总体患病率为35.27%。双眼翼状胬肉占59.27%,单眼翼状胬肉占40.73%。胬肉患病率在壮族人群为34.84%(224人),在苗族人群为35.74%(213人),两者无差异(P=0.740)。Logistic回归分析结果显示,睑板腺开口有无堵塞是翼状胬肉发生的影响因素(P=0.019),优势比OR=1.348。性别、年龄、受教育程度、是否户外活动、高血压和饮食习惯不是翼状胬肉的影响因素。用等级资料的Logistic回归进行胬肉侵入程度的多因素分析,结果显示泪河高度是翼状胬肉侵入程度的影响因素(P=0.048),泪河高度值越低,侵入程度越大。结论:云南省文山州40岁及以上壮族和苗族人群翼状胬肉患病率较高,睑板腺开口有无堵塞、泪河高度影响翼状胬肉的发生和侵入程度。     

双氯芬酸钠滴眼液控制翼状胬肉术后复发的疗效观察

目的：观察双氯芬酸钠滴眼液控制翼状胬肉术后复发的临床疗效,提供更安全的防治翼状胬肉复发的药物方案。

方法：以2011-11/2013-09因翼状胬肉在我院接受手术治疗的124例134眼患者为研究对象,随机分为试验组(双氯芬酸钠滴眼液+玻璃酸钠滴眼液)和对照组(妥布霉素地塞米松滴眼液+玻璃酸钠滴眼液),术后每周随访1次,历时3mo,对两组角膜状况、眼压和翼状胬肉复发情况进行对比观察和统计学分析。

结果：随访3mo,按计划完成随访的试验组有43例45眼,对照组有38例39眼,其中出现复发迹象的试验组有14例15眼,最终复发2例3眼,与对照组12例13眼出现复发迹象,最终复发2例2眼相比,两组差异无统计学意义( P>0.05); 对照组有6例9眼因修正眼压高于正常上限值退出试验,与试验组(0眼)相比,差异有统计学意义(P<0.05); 两组间角膜情况比较差异无统计学意义(P>0.05)。

结论：双氯芬酸钠滴眼液控制翼状胬肉术后复发是有效且安全的。     

Validity of subjective assessment as screening tool for dry eye disease and its association with clinical tests

AIM: To determine the role of subjective assessment using McMonnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests. METHODS: There were 500 patients screened for dry eye using McMonnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time (TBUT) of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease (≥grade 1). Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between McMonnies score (MS) and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability (P) value using Chi-square test of <0.005 was taken as significant. RESULTS: Dry eye prevalence with symptoms (questionnaire), Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%, 15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms (MS>20), 75.86% had a low TBUT (<10s), 58.62% had a low Schirmer’s I test (≤10 mm), 86.20% had Rose Bengal staining score of ≥1, 79.31% had Lissamine green staining score of ≥1. We found statistically significant associations between positive Schirmer test and arthritis (P<0.002), dryness elsewhere (P<0.001), contact lens use (P<0.002), systemic medication (P<0.0001), sleeping with eyes partly open (P<0.002), history of dry eyes treatment (P<0.0001), environmental factors (P<0.001), swimming (P<0.001). CONCLUSION: Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye.