妊娠期糖尿病患者眼表相关指标的临床分析

目的：应用Keratogragh 5M眼表分析仪对比妊娠期糖尿病孕妇与正常孕妇眼表相关指标。

方法：选择妊娠期糖尿病患者45例45眼及正常孕妇48例48眼作为研究对象。所有对象完成眼表疾病指数(OSDI)问卷调查对眼表进行评分,应用Keratogragh 5M测量泪河高度(TMH)、非侵入性平均泪膜破裂时间(NIKBUTav)、眼红指数、睑板腺缺失评分。得出结果后对两组各项指标进行比较。

结果：妊娠期糖尿病组及正常孕妇组的OSDI、TMH、NIKBUTav、眼红指数及睑板腺缺失评分均无差异(P>0.05)。其中OSDI分别为8.02±4.25、7.50±4.28分(P=0.557),TMH值分别为0.22±0.05、0.20±0.04mm(P=0.158),NIKBUTav值分别为8.01±2.15、8.02±1.53s(P=0.971)。

结论：妊娠期糖尿病组与正常孕妇组眼表各项指标差异均无统计学意义,妊娠期糖尿病对眼表相关指标没有明显的影响,可能与血糖控制良好有关。     

P2Y2受体激动剂局部滴眼治疗糖尿病相关干眼的临床分析

目的:观察P2Y₂受体激动剂地夸磷索钠(DQS)滴眼液治疗糖尿病相关干眼的临床疗效。方法:选取2022-01/03就诊于我院的糖尿病相关干眼患者80例160眼作为研究对象,随机分为研究组(40例80眼,使用3%DQS滴眼液治疗)和对照组(40例80眼,使用0.3%玻璃酸钠滴眼液治疗)。分别在基线、治疗后1wk, 1、3mo进行眼表疾病指数(OSDI)评分、非接触式泪河高度(NITMH)、首次非侵入式泪膜破裂时间(NIBUTf)、平均非侵入式泪膜破裂时间(NIBUTav)、睑板腺缺失评分、脂质层厚度分级、眼红分析(包括结膜等级、睫状等级)等检查,采用眼表染色评分(OSS)法进行角结膜染色评分,并分别在基线、治疗后3mo行结膜印迹细胞学和共聚焦显微镜检查。结果:治疗前后,两组患者OSDI评分、睑板腺缺失评分、结膜等级和睫状等级评分均无组间差异(P>0.05)。治疗后1、3mo,研究组OSS评分均低于对照组,NITMH、NIBUTf、NIBUTav均高于对照组(P<0.05)。治疗后3mo,研究组结膜杯状细胞密度较基线增多、角膜树突状细胞较基线减少(均P&l...     

圆锥角膜患者长期配戴硬性透气性角膜接触镜后眼表变化分析

目的： 分析圆锥角膜患者长期配戴硬性透气性角膜接触镜(RGPCL)后眼表相关参数的变化。

方法： 采用前瞻性病例研究。纳入2018-01/2022-01在我院眼视光学中心门诊确诊并验配RGPCL的原发性圆锥角膜患者113例213眼,根据圆锥角膜严重程度分为轻度圆锥角膜组42例80眼,中度圆锥角膜组54例102眼,重度圆锥角膜组17例31眼。采用Keratograph眼表综合分析仪观察三组患者戴镜前,戴镜后1 wk,1、3、6、12 mo的非侵入性泪膜破裂时间(NIBUT)、非侵入性泪河高度(NITMH)、眼红指数、脂质层厚度、角膜荧光染色、睑板腺分泌功能,Schirmer I试验及眼表疾病指数量表(OSDI)评分变化。

结果：三组患者戴镜前性别、年龄、NIBUT、NITMH、脂质层厚度、睑板腺分泌功能、Schirmer Ⅰ试验均无差异(P>0.05),而球镜、柱镜、等效球镜(SE)、BCVA、IOP_NCT、角膜前、后表面Kmax、最薄点角膜厚度、眼红指数、角膜荧光染色、OSDI评分均有差异(P<0.05)。低度圆锥角膜组NIBUT戴镜3、6、12 mo 较戴镜前有差异(P<0.05); NITMH戴镜6、12 mo较戴镜前有差异(P<0.05); 眼红指数、角膜荧光染色、OSDI戴镜1 wk,1 mo较戴镜前有差异(P<0.05); 脂质层厚度和睑板腺分泌功能戴镜12 mo较戴镜前有差异(P<0.05)。中度圆锥角膜组NIBUT戴镜6、12 mo较戴镜前有差异(P<0.05); NITMH、脂质层厚度、睑板腺分泌功能戴镜12 mo较戴镜前有差异(P<0.05); 眼红指数戴镜1 wk,1、3 mo较戴镜前有差异(P<0.05); 角膜荧光染色戴镜后1 wk较戴镜前有差异(P<0.05); OSDI评分戴镜1 wk,1 mo较戴镜前有差异(P<0.05)。高度圆锥角膜组NIBUT、NITMH、眼红指数戴镜1 wk,1、3、6、12 mo较戴镜前有差异(P<0.05); 脂质层厚度戴镜6、12 mo较戴镜前有差异(P<0.05); 角膜荧光染色和OSDI评分戴镜1 wk,6、12 mo较戴镜前有差异(P<0.05); 睑板腺分泌功能戴镜6、12 mo较戴镜前有差异(P<0.05); Schirmer Ⅰ试验戴镜12 mo较戴镜前有差异(P<0.05)。

结论： 圆锥角膜患者长期配戴RGPCL会不同程度影响眼表微循环,从而影响患者的主观舒适度,但对患者的视觉质量无明显影响,长期规范配戴RGPCL控制圆锥角膜进展具有良好的安全性。     

飞秒激光与传统LASIK术后干眼参数变化

目的：应用Keratograph 5M比较飞秒激光与传统LASIK术后干眼症状和体征的变化。

方法：收集2017-06/11行角膜屈光手术患者60例120眼,其中行飞秒激光LASIK手术30例60眼,传统LASIK手术30例60眼,于术前和术后1wk,1、3、6mo进行眼科常规检查和Keratograph 5M干眼检查并完成眼表疾病指数(OSDI)问卷。

结果：术后1wk,两组OSDI评分均高于术前(P<0.01),术后1mo两组均恢复到术前水平(P>0.05)。传统组术后1wk,1、3mo非侵入性泪膜破裂时间均比术前缩短(P<0.01),飞秒激光组术后1wk,1mo泪膜破裂时间均比术前缩短(P<0.01),术后3mo,飞秒激光组泪膜破裂时间均明显高于传统组(P<0.01)。术后1wk,1mo,两组泪河高度均较术前降低(P<0.01),脂质层均较术前变薄(P<0.05)。

结论：无论飞秒激光制瓣LASIK还是传统LASIK术都可影响泪膜的稳定性,引起干眼症状,影响程度随术后时间逐渐减弱,但飞秒制瓣能更快恢复至术前水平。     

曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症

目的：研究曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症的降眼压效果及安全性。方法：随机选取2013-03/2016-03我院收治的原发性开角型青光眼和高眼压症患者80例80眼,依据不同治疗方法分为两组：曲伏前列素滴眼液组( n=40)和拉坦前列素滴眼液组(n=40),对两组患者的临床疗效、视力、散光度、眼压及不良反应发生情况进行统计分析。结果：曲伏前列素滴眼液组患者治疗的总有效率95%(38/40)显著高于拉坦前列素滴眼液组80%(32/40),差异有统计学意义(P<0.05)。曲伏前列素滴眼液组患者治疗后视力显著高于拉坦前列素滴眼液组,差异有统计学意义(P<0.05),散光度、眼压均显著低于拉坦前列素滴眼液组,差异有统计学意义(P<0.05),不良反应发生率25%(10/40)显著低于拉坦前列素滴眼液组53%(21/40),差异有统计学意义(P<0.05)。结论：曲伏前列素滴眼液治疗原发性开角型青光眼和高眼压症比拉坦前列素滴眼液具有较好的降眼压效果及较高的安全性。     

玻璃酸钠对白内障超声乳化联合IOL植入术后眼部炎症反应和干眼症的影响

目的： 探讨玻璃酸钠滴眼液对年龄相关性白内障超声乳化联合IOL植入术后眼部炎症反应和干眼症的影响。

方法：回顾性分析我院2016-06/2017-07择期行超声乳化联合IOL植入术治疗的年龄相关性白内障患者200例200眼的临床资料,根据术后应用滴眼液的不同分为观察组和对照组(各100例)。观察组给予玻璃酸钠滴眼液,对照组给予妥布霉素地塞米松滴眼液。比较两组患者术前和术后第1、7、14d时泪膜破裂时间(break-up time,BUT)、角膜荧光素染色(fluorescein staining,FL)评分、房水蛋白浓度检查结果及眼表疾病指数(ocular surface disease index,OSDI)评分,并分析术后1、14d时结膜充血和睫状充血发生率。

结果：术前和术后1d时两组患者组间OSDI评分比较,差异均无统计学意义(P>0.05); 术后1、7、14d时两组患者OSDI评分均高于术前,差异均有统计学意义(P<0.05); 且两组患者OSDI评分在术后1d达到最高后逐渐下降(P<0.05); 观察组术后7、14d时OSDI评分均低于对照组,差异均有统计学意义(P<0.05)。术前、术后1d时两组患者组间BUT比较,差异均无统计学意义(P>0.05); 术后1、7、14d时两组患者BUT均低于术前,差异均有统计学意义(P<0.05); 且两组患者BUT在术后1d达到最低后逐渐升高(P<0.05); 观察组术后7、14d时BUT均高于对照组,差异均有统计学意义(P<0.05)。术前、术后1d时两组患者组间FL比较,差异均无统计学意义(P>0.05); 术后1、7、14d时两组患者FL与术前比较,差异均有统计学意义(P<0.05); 且两组患者FL在术后1d达到最高后逐渐下降(P<0.05); 观察组术后7、14d时FL均低于对照组,差异均有统计学意义(P<0.05)。两组患者术后1d结膜充血、睫状充血发生率比较,差异均无统计学意义(P>0.05); 术后14d两组患者结膜充血、睫状充血发生率均低于术后1d,差异均有统计学意义(P<0.05),但对照组术后14d结膜充血、睫状充血发生率低于观察组,差异有统计学意义(P<0.05)。术后1、7、14d两组患者房水蛋白浓度与术前比较,差异均有统计学意义(P<0.05); 且两组患者房水蛋白浓度在术后1d达到最高后逐渐下降(P<0.05),对照组术后7、14d房水蛋白浓度均低于观察组,差异均有统计学意义(P<0.05)。

结论：玻璃酸钠滴眼液改善年龄相关性白内障超声乳化联合IOL植入术后干眼症状作用较妥布霉素地塞米松滴眼液显著,但是对于眼部炎症作用没有妥布霉素地塞米松滴眼液强。综合考虑,对于炎症作用轻、创伤小的超声乳化联合IOL植入术后患者可选玻璃酸钠滴眼液。     

The efficacy of autologous serum eye drops for severe dry eye syndrome: a randomized double-blind crossover study

Background

To evaluate the efficacy of autologous serum (AS) eye drops for the symptomatic relief of severe dry eye syndrome (DES), as compared to conventional preservative-free artificial tears (PFAT).

Methods

This prospective double-blind randomized crossover study used the Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), Schirmer’s Test, and OXFORD Scale at baseline and after each of two 1-month treatment periods to measure the effect of 20 % diluted AS eye drops vs. PFAT in 20 consecutive severe DES patients that were refractory to conventional treatment.

Results

The study included 20 (18 female and two male) severe DES patients (40 eyes). Significantly higher TBUT (P?<?0.001, Wilcoxon signed-rank test) and a greater decrease in OSDI score (55.18 % decrease in the AS treatment group vs. 19.50 % decrease in the PFAT treatment group) (P?<?0.001, Student’s paired samples t-test) were observed in the AS treatment group after 1 month of treatment. There wasn’t a significant difference in Schirmer’s test and OXFORD conjunctival and corneal vital dying grading scores between the two treatment groups after 1 month of treatment (P?>?0.05 [Mann–Whitney U test]).

Conclusions

AS eye drops were more effective than conventional eye drops for improving tear film stability and subjective comfort in patients with severe DES.     

闭角型青光眼合并白内障急性发作眼与对侧眼术后眼表变化

目的:探讨原发性闭角型青光眼(PACG)合并白内障急性发作眼与对侧眼术后眼表变化。方法:选取2021-01/2022-01于郑州大学附属郑州中心医院就诊的单眼发作的急性PACG合并白内障患者40例,急性发作眼行小梁切除术联合超声乳化白内障吸除人工晶状体植入术,对侧眼行超声乳化白内障吸除人工晶状体植入术,分别于术前、术后1、3、6mo行眼表疾病指数(OSDI)问卷调查及非侵入性首次泪膜破裂时间(NifBUT)、非侵入性平均泪膜破裂时间(NiaBUT)、泪河高度(TMH)检查。结果:纳入患者术后1、3mo OSDI评分(14.72±3.07、11.39±2.24分)较术前(9.68±1.98分)明显升高(均P<0.0083),术后6mo(10.18±1.84分)与术前无明显差异;发作眼术后1、3mo NifBUT较术前明显降低,术后1、3、6mo NiaBUT较术前明显降低(均P<0.0083);对侧眼术后1mo NifBUT和NiaBUT较术前均明显降低(均P<0.0083),术后3、6mo与术前无明显差异。手术前后纳入患者发作眼和对侧眼TMH均无差异(P>0.0...     

Keratograph 5M评估玻璃体切除手术对眼表的影响

目的：该研究旨在应用Keratograph 5M评估玻璃体切除手术(PPV)对眼表的影响。

方法：本研究纳入23G玻璃体切除手术的患者30例30眼。分别于手术前、手术后1、2、4、8及12wk行眼表疾病指数(OSDI)问卷评分,采集眼表参数包括泪河高度(TMH)、非侵入性泪膜破裂时间(NITBUT)和眼红指数,并进一步分析各临床参数之间的相关性。

结果：玻璃体切除术后4wk内,畏光、异物感较术前显著增加,但是手术后8、12wk降至术前水平; 术后1wk眼胀不适较前显著增加,但术后2、4、8及12wk与术前无显著差异。OSDI评分在术后4wk内显著增加,但在术后8wk及12wk降至术前水平。TMH在术后2wk较前增高,但与术前相比差异无统计学意义。首次NITBUT和平均NITBUT在术后8wk内显著缩短,但术后12wk延长至术前水平。眼红指数在术后4wk内显著增加,但术后8wk降至术前水平。首次NITBUT和平均NITBUT在每次随访时间点均呈显著正相关,TMH与平均NITBUT在术后1wk呈显著正相关。

结论：Keratograph 5M可作为评估玻璃体切除手术对眼表影响的一种可靠方法。玻璃体切除手术可引起早期眼表症状及体征的改变,但是这些改变在手术后12wk内将逐渐恢复到术前水平。     

眼表综合分析仪评价干眼患者相关指标的临床分析

目的 评价眼表综合分析仪在干眼患者中的应用价值。方法 横断面研究。选择70例（135眼）干眼患者作为研究对象。检查指标包括眼表疾病指数（OSDI）评分、泪液分泌试验（SⅠT）、睑板腺分泌物性质检查,以及利用眼表综合分析仪系统--Keratograph 5M进行泪河高度测量、泪膜破裂时间（BUT）测定以及睑板腺检查。Keratograph 5M与传统检查方法之间的相关性、干眼患者睑板腺状况评分与OSDI评分及BUT的相关性用Pearson相关及线性回归进行分析,Keratograph 5M分析眼表状况的重测信度用组内相关系数评价。结果 70例（135眼）患者OSDI评分为（15.8±3.4）分,SⅠT为（6.0±7.7）mm,泪河高度为（0.27±0.13）mm,BUT为（7.9±5.5）s。睑板腺分泌物评分为（3.3±1.4）分,睑板腺缺失面积评分为（3.4±1.6）分。测得的BUT时间越短,SⅠT越短（r=0.474,P＜0.01）;泪河高度越低,SⅠT越短（r=0.432,P＜0.01）。睑板腺分泌物评分、睑板腺照相评分与OSDI评分呈正相关（r=0.673、0.752,P<0.05）,与BUT呈负相关（r=-0.638、-0.603,P<0.05）。眼表综合分析仪的检查结果具有较好的重测信度（ICC值在0.84~0.89之间）。结论 眼表综合分析仪能够直观地评价干眼患者眼表状况,是一种非接触性、无创、可重复性强的快速检查手段,具有实际临床应用价值。     

超声乳化白内障摘除联合小梁切除术对眼表的影响

目的：采用Keratograph 5M眼表综合分析仪比较小梁切除术和超声乳化白内障摘除联合小梁切除术对眼表的影响。

方法：纳入原发性闭角型青光眼合并白内障患者62例62眼,按手术方式分为两组：小梁切除术组32例32眼,超声乳化白内障摘除联合小梁切除术组(青白联合手术组)30例30眼。运用Keratograph 5M评估术前,术后3d,1、 3mo的非侵入性首次泪膜破裂时间(NifBUT)、非侵入性平均泪膜破裂时间(NiaBUT)、泪河高度(TMH)和角膜荧光素染色评分(CFS)。

结果：术前两组患者眼表参数比较差异均无统计学意义(P>0.05)。术后3d青白联合手术组的NiaBUT、NifBUT、CFS、TMH最差,分别为10.13±1.48、12.59±1.96s、0.80±0.22分与0.31±0.02mm,变化幅度明显高于小梁切除组(均 P<0.05),术后1mo两组的各项指标均有所恢复,但直到术后3mo仍未完全恢复到术前水平。

结论：眼表综合分析仪可以客观、精确地用于评估抗青光眼手术后泪膜功能的变化。在术后3mo短期内超声乳化白内障摘除联合小梁切除术比单纯小梁切除术对眼表的影响更为严重,提示在此期间应加强对眼表的护理。     

Efficacy of topical cyclosporine 0.05% and osmoprotective lubricating eye drops in treating dry eye disease and inflammation

Purpose:To evaluate the effect of topical cyclosporine 0.05% and osmoprotective lubricating eye drops on patients with dry eye disease (DED) with inflammation as measured by raised tear matrix metalloproteinases (MMP-9).Methods:This prospective study included 106 eyes of 53 patients diagnosed with DED based on any of the following DED criteria (Ocular Surface Disease Index [OSDI] score >12, tear film breakup time [TBUT] <10 s, Schirmer’s I test result <10 mm/5 min, ocular surface staining). Ocular surface inflammation was assessed by assessing MMP-9 positivity from tears of the patients in the study (Inflammadry kit Quidel corporation). Patients were prescribed osmoprotective lubricating eye drops (Osmodrops, Cipla Ltd) four times a day and cyclosporine A 0.05% eye drops (Imudrops, Cipla Ltd) twice a day for 6 months. Efficacy of the formulations was evaluated by OSDI scores, Schirmer’s test, TBUT change, reduction in ocular surface staining, and reduction in MMP-9 levels after 6 months of usage. Check P value and add from resultsResults:After 6 months of topical therapy, improvement was observed in OSDI scores (mean pretreatment: 25.7 ± 12.8, and mean posttreatment: 15.2 ± 8.4), P < 0.001. There was also reduction number of patients who were MMP-9 positive. Out of 75 eyes that tested MMP-9 positive, 70.66% showed reduction in MMP-9 levels P < 0.0001). Ocular surface staining also improved.Conclusion:Topical osmoprotective lubricating eye drops and cyclosporine A 0.05% reduce inflammation in cases of DED, which correlates with improvement in OSDI scores, ocular surface staining, and reduction in inflammation as measured by levels of tear MMP-9.     

干眼患者泪液结晶图和脂质层异常的关系研究

目的：评估干眼患者泪液结晶图中外层透明带的临床意义,探索评估泪液脂质层的新方法。

方法：随机选取2018-05/2019-07于在我院就诊的干眼患者47例47眼(均取右眼数据进行分析),所有入组患者均行眼表疾病指数(OSDI)问卷评分,采用DR-1泪膜干涉成像仪行脂质层分级检测,眼表综合分析仪行非侵入式泪膜破裂时间(NIBUT)和泪河高度检查,采集泪液行泪液结晶试验,拍摄泪液结晶图全貌,使用Digimizer软件测量结晶图,计算结晶图外层透明带的面积占比,并分析其与OSDI评分、脂质层分级、泪河高度、NIBUT的相关性。

结果：本研究纳入患者泪液结晶图透明带面积占比与OSDI评分呈负相关(r=-0.764,P<0.05),与DR-1成像仪脂质层分级呈负相关(r=-0.838,<0.05),与NIBUT呈正相关(r=0.575,P<0.05),与泪河高度无明显相关(r=-0.237,P=0.112)。

结论：检测泪液结晶图外层透明带可有效评估泪液脂质层情况,透明带面积占比越大,脂质层越厚。该检测方法具有结果可量化、重复性较好、设备要求低等优点。     

地夸磷索钠联合清润养目口服液治疗白内障术后干眼

目的:探讨地夸磷索钠滴眼液联合清润养目口服液治疗白内障超声乳化摘除术联合人工晶状体植入术后干眼的临床疗效。方法:选取2020-09/2021-01就诊于我院眼科的白内障术后干眼患者57例65眼作为研究对象,采用随机数字表法分为对照组(28例32眼,使用3%地夸磷索钠滴眼液治疗)和观察组(29例33眼,使用3%地夸磷索钠滴眼液联合清润养目口服液治疗)。比较两组患者术前1d,术后1wk(治疗前),1mo(治疗后)眼表疾病指数(OSDI)量表评分、非侵入性泪膜破裂时间(NIBUT)、泪液分泌试验(SⅠt)、角膜荧光素钠染色(CFS)评分、中医症状评分等指标。结果:治疗后,观察组和对照组总有效率分别为88%、75%,两组患者OSDI评分、NIBUT、SⅠt均较治疗前明显改善(P<0.05),观察组治疗后NIBUT、SⅠt、CFS评分、中医症状评分均优于对照组(P<0.05)。治疗期间,两组患者均无不良反应发生。结论:地夸磷索钠滴眼液联合清润养目口服液可改善白内障术后干眼的主观症状及客观临床指标,为白内障围手术期干眼的眼表管理提供了新的治疗方案。     

玻璃酸钠联合氯替泼诺滴眼液与单纯玻璃酸钠滴眼液治疗儿童干眼的疗效比较

目的：探讨玻璃酸钠联合氯替泼诺滴眼液对比单纯玻璃酸钠滴眼液在临床治疗干眼患儿时的作用和安全性。

方法：选取2014-08/2016-08于本院接受人工泪液治疗的水液缺乏型干眼儿童共128例256眼,依据随机数字表法,将两组患儿随机分为联合组和对照组各64例128眼,联合组给予玻璃酸钠联合氯替泼诺滴眼液治疗,对照组给予单纯的玻璃酸钠滴眼液治疗。于治疗前和治疗后2、6wk行眼表综合分析系统(Keratograph 5M)检查,测定泪膜破裂时间(tear break-up time,BUT)、泪河高度、睑板腺红外线照相,裂隙灯下观察角膜荧光素染色,对各项观察指标进行统计学处理。

结果：治疗2wk后两组患儿的泪河高度和BUT水平均高于治疗前,睑板腺评分和角膜荧光素染色评分均低于治疗前,差异有统计学意义(P<0.05); 治疗6wk后,两组患儿的泪河高度和BUT水平均高于治疗前和治疗2wk后,睑板腺评分和角膜荧光素染色评分均低于治疗前和治疗2wk后,差异有统计学意义(P<0.05); 治疗2、6wk后,联合组患儿的泪河高度和BUT水平均高于同时期对照组,而睑板腺评分和角膜荧光素染色评分均低于同时期对照组,差异有统计学意义(P<0.05); 两组患儿用药前后眼压对比差异均无统计学意义(P>0.05)。

结论：玻璃酸钠联合氯替泼诺滴眼液较单纯使用玻璃酸钠滴眼液在临床治疗干眼儿童时取得了更好的治疗效果,同时安全性和耐受性较好。     

Efficacy of ripasudil in reducing intraocular pressure and medication score for ocular hypertension with inflammation and corticosteroid

AIM: To investigate the efficacy of ripasudil, a Rho kinase inhibitor, in reducing intraocular pressure (IOP) and medication scores of anti-glaucoma drugs in patients with ocular hypertension with inflammation and corticosteroid. METHODS: The study included 11 patients diagnosed with ocular hypertension with inflammation and corticosteroid, all of whom were prescribed ripasudil eye drops and followed up for at least 2y after the initiation of treatment. IOP was measured using a non-contact tonometer before enrollment and at each follow-up visit. The medication score of glaucoma eye drops was calculated for each patient. RESULTS: The mean IOP (26.4±2.9 mm Hg before treatment) significantly decreased after ripasudil therapy (13.7±3.3 mm Hg at 3mo) and remained stable in the low-teens during the 2-year follow-up period (P<0.0001). A significant decrease in the medication score was observed at 12mo or later after the initiation of ripasudil therapy (P<0.05). Both baseline medication scores and glaucomatous optic disc change rates were significantly higher in the five eyes that required glaucoma surgery during the 2-year observation period than the 10 eyes that did not require surgery. CONCLUSION: Our results demonstrate the efficacy of ripasudil, in reducing IOP and the medication score over a 2-year treatment period in patients with ocular hypertension with inflammation and corticosteroid. Our findings also suggest that ripasudil could reduce the IOP in uveitic glaucoma patients with both lower baseline medication score and lower glaucomatous optic disc change rate.     

Children with dry eye type conditions may report less severe symptoms than adult patients

Background

To compare the symptom scores of children with those of adults with the same degree of mild ocular surface signs.

Methods

This study included patients with at least one ocular surface symptom and sign. Data obtained from 45 subjects aged 8.79?±?2.95 yr (Mean ± SD) (pediatric group) and 45 adults aged 52.87?±?10.87 yr (adult group) who were matched to each pediatric patient based on ocular surface signs were analyzed. Demographic data including age and sex; parameters of ocular surface signs including fluorescein staining score, tear film breakup time and Schirmer test score; symptom scores including ocular surface disease index (OSDI) and visual analog scale (VAS) were assessed and compared between the two groups.

Results

Significant differences emerged in sex ratio as well as in age between the two groups (P?<?0.001, for both). Regarding ocular surface signs and tear film tests, the study revealed no significant differences in fluorescein staining score (1.44?±?1.95 vs. 1.40?±?1.68 P?=?0.913), tear film break up time (4.96?±?1.94 vs. 3.82?±?1.85 s, P?=?0.612) and Schirmer score (12.79?±?9.05 vs. 10.11?±?8.45 mm / 5 min, P?=?0.370). Regarding dry eye symptoms, both OSDI and VAS were significantly lower in the pediatric group (P?=?0.001 and?<?0.001, respectively) than in the adult group.

Conclusion

Pediatric patients with mild ocular surface damage may report fewer dry eye symptoms compared to adult patients with similar stages of ocular surface damage.     

小梁切除术前应用玻璃酸钠滴眼液对术后眼表恢复的促进作用

目的　评价3 g·L^-1玻璃酸钠滴眼液术前干预对小梁切除术后眼表恢复的促进作用。方法　前瞻性病例对照研究。选取2017年1月至2018年3月于我院住院拟行小梁切除术治疗的原发性慢性闭角型青光眼和原发性开角型青光眼患者52例63眼,随机分为干预组和对照组。干预组从术前1周开始给予3 g·L^-1玻璃酸钠滴眼液,对照组从术后1 d开始给予3 g·L^-1玻璃酸钠滴眼液,均于术后1个月停药。术前两组患者基本情况匹配,比较两组术后1周、1个月和3个月眼表疾病指数(ocular surface disease index,OSDI)、角膜荧光染色评分、泪膜破裂时间(tear break-up time,BUT)和泪液分泌试验结果。结果　两组患者术前均有不同程度干眼症状和体征。术后1周两组患者干眼症状均较术前加重,且以对照组症状加重更为显著,表现为OSDI评分和角膜荧光染色评分均较术前增加,BUT较术前缩短（均为P<0.05）;术后1个月干预组OSDI评分、角膜荧光染色评分和BUT分别为（14．43±5．33）分、（0.71±0.56）分、（8.65±3.01）s,均优于对照组的（22．08±6．71）分、（1.38±0.88）分、（7.12±2.98）s,差异均有统计学意义（均为P<0.01）;术后3个月两组各项指标比较差异均无统计学意义（均为P>0.05）。结论　小梁切除术前应用3 g·L^-1玻璃酸钠滴眼液可以有效预防和减轻术后眼表损伤,缩短眼表恢复时间,改善患者干眼症状。     

氟米龙联合玻璃酸钠滴眼液治疗干眼的效果及对泪液中炎症因子的影响

目的:探讨氟米龙联合玻璃酸钠滴眼液治疗干眼的效果及对泪液中炎症因子的影响。方法:采用前瞻性随机对照研究设计,连续收集2017-02/2019-12我院眼科收治的干眼患者116例232眼作为研究对象,采用随机数字表法将患者分为两组,对照组58例116眼给予玻璃酸钠滴眼液治疗,观察组58例116眼在对照组基础上给予0.1%氟米龙滴眼液治疗。于治疗前及治疗2、4wk时进行眼表疾病评分指数(OSDI)评分,测定泪膜破裂时间(BUT)、基础泪液分泌试验(SⅠt)、角膜荧光素染色(FL)评分,进行眼表综合分析测定泪河高度(TMH)、非侵入性泪膜破裂时间(NIKBUT),采用结膜印记试验测定上皮细胞分级及杯状细胞密度,测定泪液中白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、转化生长因子-β1(TGF-β1)水平,评估两种治疗方法的疗效及安全性。结果:观察组及对照组总体有效率分别为94.8%、82.8%(P<0.05)。治疗4wk时,观察组SⅠt、BUT、NIKBUT高于对照组,FL评分、OSDI评分低于对照组(P<0.05);观察组杯状细胞密度高于对照组(P<0.05)。观察组治疗2、4wk时泪液中IL-6、IL-1β显著低于对照组,治疗4wk时TGF-β1显著高于对照组(P<0.05)。两组患者不良反应发生率分别为3.4%、1.7%(P>0.05)。结论:氟米龙联合玻璃酸钠可显著改善干眼患者临床症状,提高泪膜稳定性,其机制可能与其对眼表炎症因子的调节作用相关。     

Influence of pars plana vitrectomy on ocular surface using noninvasive Keratograph 5M

AIM: To evaluate the influence of pars plana vitrectomy (PPV) on ocular surface using Keratograph 5M. METHODS: Totally 30 consecutive patients (30 eyes) undergoing primary 23-gauge PPV were recruited in the study. Ocular Surface Disease Index (OSDI) questionnaire was performed. Ocular surface parameters, including tear meniscus height (TMH), noninvasive tear break up time (NITBUT) and bulbar redness score were obtained preoperatively, in 1, 2, 4, 8 and 12wk postoperatively by Keratograph 5M. Correlations between all the clinical parameters were analyzed further. RESULTS: The percentages of both photophobia and gritty within 4wk after PPV were significantly higher than pre-operation, while they decreased to the preoperative levels in both 8wk and 12wk postoperatively. The percentage of sore eyes in the first week postoperatively was significantly higher than pre-operation, but there were no significant differences between the percentages of pre-operation and 2, 4, 8, and 12wk postoperatively. OSDI score increased significantly within 4wk postoperatively, but it returned to the preoperative level in 8 and 12wk. TMH increased with 2wk postoperatively, but there were no significant differences compared with preoperation. Both NITBUT-first and NITBUT-average shortened significantly within 8 weeks postoperatively, but they gradually improved to the preoperative levels in 12wk. Bulbar redness score was significantly higher than the preoperative level within 4wk postoperatively, but it returned to the preoperative level in 8wk. NITBUT-first and NITBUT-average had a significant positive correlation at each visit. TMH had a significant positive correlation with NITBUT-average in the first week postoperatively. CONCLUSION: Keratograph 5M can provide a reliable noninvasive method to assess the influence of PPV on the ocular surface. PPV may cause various changes in both symptoms and signs of ocular surface damages at the early stage, while all these changes will return to preoperative levels gradually in 12wk postoperatively.