白内障超声乳化术后角膜内皮细胞的形态学变化

目的探讨白内障超声乳化术对角膜内皮细胞（CEC）形态学的影响。方法自身对照研究。50例（50眼）行白内障超声乳化联合人工晶状体植入术,用角膜内皮显微镜（CSM）对手术前及术后12个月角膜中央及5.5 mm处12点、3点、6点、9点5个点位,每一点位的5个区域（中央-C、上方-S、颞侧-T、鼻侧-N、下方-I）,共25个点的CEC进行拍照及图像合并。计算图像数字化后的CSM常用参数及新参数：细胞分型比例、细胞边长变异、角度变异、暗区面积等。采用单因素方差分析中的Dunnett-q检验比较各象限参数与中央区参数,手术前后的参数比较采用配对t检验。结果术后12个月与术前比较,细胞密度（CD）[术前（2 854±290）cells/mm2、术后（2 035±150）cells/mm2,t=17.86]、平均细胞面积（Save）[术前（351±29）μm2、术后（606±59）μm2,t=27.14]差异均有统计学意义（P均<0.01）;六角形细胞比例（HEX）[术前（63.5±4.2）%、术后（61.2±3.7）%]、六角形细胞边长变异（Ev）[术前（19.7±2.5）%、术后（20.2±2.2）%]、六角形细胞角度变异（Av）（术前158.4°±27.5°、术后155.3°±19.1°）、多边形细胞比例[术前（12.3±2.7）%、术后（11.2±3.4）%]、五边形细胞比例[术前（4.8±2.2）%、术后（5.7±2.4）%]的差异均无统计学意义;CEC暗区数量（术前0.31±0.14、术后0.83±0.25,t=18.65）及暗区面积[术前（81.3±55.2）µm2、术后（244.9±131.6）µm2,t=5.25]的差异均有统计学意义（P均<0.01）。术后12个月,以上CEC参数在角膜中央5.5 mm范围内的4个代表性点位（12点位、3点位、6点位、9点位）和中央区相比,差异均有统计学意义（P均<0.01）。结论白内障术后的较长时间内CEC未完全再平均分布,采用多象限多点位分析的方法更能反映整个角膜CEC的特点。     

A Case of Corneoscleral Dellen after Medial Rectus Recession Combined with Pterygium Resection in Right Eye

 Purpose: A case of corneoscleral dellen after medial rectus recession combined with pterygium resection was reported. Methods: Case report Results: A male patient aged 48 years had ghost for 1 year after acoustic neuroma resection. The patient was diagnosed with rectus paresis in the right eye. He successfully underwent medial rectus recession combined with pterygium resection. A corneoscleral dellen with a size of 2×2 mm was observed at 20 d postoperatively. The thinnest cornea was 147um, diagnosed as corneoscleral dellen, which was cured after undergoing corneal limbal stem cell transplantation with conjunctival flap. Conclusion: Corneoscleral dellen is non-infectious corneoscleral ulcer caused by complex reasons. Most cases recovered by using artificial tears, antibiotic ointment and eye wrap, and other patients required corneal limbal stem cell transplantation with conjunctival flap, even keratoplasty. It is recommended that the patients with strabismus combined with pterygium underwent conjunctival flap transplantation at early stage to prevent the incidence of surgical complications.     

白内障超声乳化术后角膜内皮细胞的形态学变化

目的 探讨白内障超声乳化术对角膜内皮细胞（CEC）形态学的影响.方法 自身对照研究.50例（50眼）行白内障超声乳化联合人工晶状体植入术,用角膜内皮显微镜（CSM）对手术前及术后12个月角膜中央及5.5 mm处12点、3点、6点、9点5个点位,每一点位的5个区域（中央-C、上方-S、颞侧-T、鼻侧-N、下方-I）,共25个点的CEC进行拍照及图像合并.计算图像数字化后的CSM常用参数及新参数：细胞分型比例、细胞边长变异、角度变异、暗区面积等.采用单因素方差分析中的Dunnett-q检验比较各象限参数与中央区参数,手术前后的参数比较采用配对t检验.结果 术后12个月与术前比较,细胞密度（CD）[术前（2 854-＆#177;290） cells/mm2、术后（2 035＆#177;150）cells/mm2,t=17.86]、平均细胞面积（Save）[术前（351土29）μm2、术后（606＆#177;59）μm2,t=27.14]差异均有统计学意义（P均＜0.01）;六角形细胞比例（HEX）[术前（63.5＆#177;4.2）％、术后（61.2＆#177;3.7）％]、六角形细胞边长变异（Ev）[术前（19.7＆#177;2.5）％、术后（20.2＆#177;2.2）％]、六角形细胞角度变异（Av）（术前158.4＆#176;＆#177;27.5＆#176;、术后155.3＆#176;＆#177;19.1＆#176;）、多边形细胞比例[术前（12.3＆#177;2.7）％、术后（11.2＆#177;3.4）％]、五边形细胞比例[术前（4.8土2.2）％、术后（5.7＆#177;2.4）％]的差异均无统计学意义;CEC暗区数量（术前0.31＆#177;0.14、术后0.83＆#177;0.25,t=18.65）及暗区面积[术前（81.3＆#177;55.2）μm2、术后（244.9＆#177;131.6）μm2,t=5.25]的差异均有统计学意义（P均＜0.01）.术后12个月,以上CEC参数在角膜中央5.5 mm范围内的4个代表性点位（12点位、3点位、6点位、9点位）和中央区相比,差异均有统计学意义（P均＜0.01）.结论 白内障术后的较长时间内CEC未完全再平均分布,采用多象限多点位分析的方法更能反映整个角膜CEC的特点.     

Heilungsverlauf und Komplikationen nach Augenmuskeloperationen

BACKGROUND: Varying reports on the incidence of operative and postoperative complications following eye muscle surgery have been published. The purpose of this study was to quantify complications after various types of eye muscle surgery as well as minor pathological changes of the anterior and posterior segment. PATIENTS AND METHODS: This prospective study included all patients who underwent eye muscle surgery at the Department of Strabismology and Neuroophthalmology, Giessen, from January to May 1998. Five hundred eyes of 377 patients aged 2-82 years were included. The spectrum of procedures comprised: recessions, resections, tucks, R&R procedures, transpositions, bimedial retroequatorial myopexies, and revisions of rectus and oblique muscles. All patients were examined 1 day preoperatively and 1 day, 1 week, and 3 months postoperatively. Any complications and even minor pathological changes of the anterior and posterior segment were documented. Some changes were assessed by means of a score (0-3). RESULTS: One day postoperatively, 30% of eyes had inflammatory pseudoptosis, most of them mild. Conjunctival swelling and injection were frequently mild and moderate, after 1 week mostly mild. Conjunctival irritation was more pronounced following resection than tucking. Punctate epithelial keratopathy was noted in 1.6% of cases (first postoperative day), dellen in 4.3% (first postoperative week). Three months postoperatively, 14.3% of eyes had biomicroscopically visible conjunctival folds and 91.3% had minimal conjunctival scars. None of the patients had a scleral perforation or other serious complication. CONCLUSIONS: Eye muscle surgery rarely entails complications. Revisions due to organic pathological changes are extremely rare. Possible development of dellen requires check-up 4-7 days postoperatively. Tucking of rectus muscles causes less conjunctival irritation than resection.     

先天性白内障术前视力特征及对术后视力恢复的影响

先天性白内障术前视力特点:致密核性白内障(CDNC)580眼中,主要分布在低视力级和盲级;全性白内障(CTC)324眼中,主要分布在盲级;前极性白内障(CAPC)212眼中,主要分布在VA>0.3级和低视力级;后极性白内障(CPPC)207眼中,三个级区内大致均分;绕核性白内障(CPNC)218眼中,主要分布在低视力级和盲级,术后最佳矫正视力特点:CDNC352只眼中,主要分布在>0.3级和低视力级;CTC253只眼中,主要分布在低视力级和盲级;CAPC210眼中,主要分布在>0.3级;CPPC174眼中,也主要分布在>0.3级,CPNC207眼中,主要分布在>O.3级和低视力级.5种先天性白内障中,术前和术后视力较好的是先天性前极性和后极性白内障,尤以前极性白内障为甚,说明只要治疗得当,该型白内障愈后情况是较好的.     

老视前期近视患者LASIK术后相对性调节的变化

目的 探讨老视前期近视患者准分子激光原位角膜磨镶术(LASIK)檄后相对性调节的变化.方法 对接受LASIK手术治疗的老视前期近视患者58只眼,按平时戴镜情况分为两组:角膜接触镜组(13例26只眼)和框架眼镜组(16例32只眼),于术前、术后10d、1月和3月测定正负相对调节.结果 角膜接触镜组术后10 d和1月的负相对调节与术前相比差异无统计学意义(P＞0.05),而术后3月比术前有所增加(p=0.019),框架眼镜组术后各期与术前相比差异无统计学意义(P＞0.05).两组术后10d正相对调节与术前相比差异有统计学意义(P＞0.01),术后1月、3月与术前相比差异无统计学意义(P＞0.05),虽然术前角膜接触镜组明显高于框架眼镜组(P=0.028),但是术后10 d的下降值两组间差异无统计学意义(P=0.695).结论 老视前期近视患者LASIK术后出现的暂时性正相对调节量的下降是术后早期出现视疲劳的原因之一.     

结膜松弛症新月形切除术与药物治疗临床疗效比较

目的:为了寻求安全、简便、经济、有效治疗结膜松弛症的方法,评价结膜松弛症结膜新月形切除术和药物治疗两组的临床疗效。方法:采用前瞻性随机分组对照研究方法,将2009-04/2010-03在上海市眼病防治中心按照结膜松弛症诊断标准入选治疗患者30例60眼按患者入选编号末位数的奇偶数随机分为两组。奇数组15例30眼行结膜新月形切除术手术;偶数组15例30眼行消炎人工泪液保守治疗。药物治疗和手术后第2,4,8wk两组分别随访患者症状改善程度、裂隙灯观察结膜松弛切除程度、手术切口愈合情况、手术并发症评价、测量泪河、BUT及氯霉素眼液尝味试验。结果:结膜新月形切除术后4wk眼表面疾病指数(OSDI)明显降低,术后8wkOSDI趋于稳定,与药物治疗组比较,差异有统计学意义(t=2.801,P=0.008)。结膜新月形切除术后2,4,8wk泪河明显改善,与药物治疗组比较差异有统计学意义(P<0.01),两组BUT≥10s者比较治疗后2,4wk差异无统计学意义(P>0.05)。治疗后8wk比较差异有统计学意义(χ2=5.455,P=0.020)。结膜新月形切除术后8wk,30眼中氯霉素眼液尝味试验阳性者14眼(47%);药物治疗组30眼中氯霉素眼液尝味试验阳性者6眼(20%)。两组比较差异有统计学意义(χ2=4.800,P=0.028)。结膜新月形切除术后2wk松弛结膜残留积分10分,4wk7分,8wk6分。手术并发症积分术后2wk6分,4wk12分,8wk8分。结论:球结膜新月形切除术治疗结膜松弛症安全、有效;消炎人工泪液能部分改善结膜松弛症症状。     

近视眼LASIK术后高阶像差的变化

目的观察中低度近视行准分子激光原位角膜磨镶术（LASIK）对人眼高阶像差的影响。方法选择中低度近视病例40例,80只眼,行LASIK手术,使用Wavelight的Allegretto波前像差仪观察术后1月、术后3月、术后6月时,C7（慧差）、C12（球差）、RMSH（总高阶像差均方根）三个变量。结果 LASIK术后C7、C12、RMSH在术后1月、术后3月均呈逐渐上升趋势（P〈0.01）,在术后3个月时达到高峰,C12、RMSH术后6月时稍有下降（P〈0.05）,术后6月时趋于稳定（P〉0.05）,但均值仍高于术前水平。结论 LASIK术后早期高阶像差明显增加,随时间有下降的趋势。     

Corneal dellen in the limbal approach to rectus muscle surgery.

A retrospective study of 170 cases of horizontal rectus muscle surgery performed during the years 1969 and 1970 at the University of Illinois Eye and Ear Infirmary revealed a 6-5 per cent incidence of dellen with the limbal approach to the muscle and a 2-2 per cent of incidence of dellen with the nonlimbal or direct approach to the muscle. This was significant to the 5 per cent level of confidence by the chi2 test. We feel that this finding of an increased incidence of dellen with the limbal approach complements the current theory of desiccation as the cause of corneal dellen. We do not recommend abandonment of the limbal approach to rectus muscle surgery because of this finding, but suggest that surgeons scrutinize more carefully their postoperative patients for dellen. If dellen do not occur careful trimming of the conjunctiva to avoid bunching and thickening may perhaps eliminate them.     

内斜视V征的手术治疗和临床观察

目的探讨内斜视V征的临床特点和手术疗效。方法总结我院2007年至2010年38例(76眼)住院手术的内斜视V征患者资料,其中合并下斜肌功能亢进者31例行下斜肌减弱术和常规水平直肌后退和(或)缩短术;不合并下斜肌功能亢进者7例分别行双眼内直肌后徙术和(或)联合肌止端向闭口端移位术、外直肌缩短术并肌止端向上移位术。检查分析患者手术前后斜视度数、双眼视功能及手术效果。结果术前上、下注视眼位的垂直斜视角之差为15△～40△,平均22.7△,其中15△～20△者21例(55.26%),21△～30△者14例(36.84%),≥31△者3例(7.89%);术后上、下注视眼位的垂直斜视角之差为5△～20△,平均6.8△,其中5△～14△者34例(89.47%),15△～20△者4例(10.53%);术前、术后垂直斜视角差异有统计学意义(t=16.907,P<0.05)。术前水平斜视角平均18.4△,术后为4.6△,差异有统计学意义(t=24.624,P<0.05)。术前、术后同视功能差异有统计学意义(χ2=16.110,P<0.05)。术后眼位正位、V征消失者29例(76.32%),V征缓解者5例(13.16%),V征仍然存在者4例(10.53%)。结论内斜视V征发病年龄早,多合并下斜肌功能亢进,减弱下斜肌功能可有效矫治内斜视V征。不合并下斜肌功能亢进者,行内直肌后徙联合肌止端向闭口端移位术,也可有效缓解内斜视V征。     

Epi-LASIK术后角膜中央知觉及泪膜稳定性的临床观察

目的:观察微型角膜刀准分子激光上皮瓣下角膜磨镶术(epipolis laser in situ keratomileusis,Epi-LASIK)术后角膜中央知觉和泪膜稳定性的变化。方法:选择92例184眼近视患者行Epi-LASIK手术,其中低中度近视组48例96眼,高度近视组44例88眼。观察术眼术前及术后1,3,6mo的角膜中央知觉、泪膜破裂时间(break-up time,BUT)、泪液分泌量(SchirmerⅠ实验),并对结果进行统计学分析。结果:两组术后角膜中央知觉及泪膜稳定性均有不同程度的下降。低中度近视组术后1mo角膜中央知觉及BUT与术前比有显著性差异(P<0.05),术后3mo时角膜中央知觉及BUT已恢复。高度近视组术后1,3mo角膜中央知觉及BUT与术前比有显著性差异(P<0.05),术后6mo时角膜中央知觉及BUT已基本恢复。高度近视组角膜中央知觉和泪膜稳定性减退更明显,恢复时间更长。两组术后泪液分泌量(SchirmerⅠ实验)分别与术前相比无显著性差异。结论:Epi-LASIK术影响角膜中央知觉和泪膜的稳定性。高度近视对角膜中央知觉和泪膜稳定性的影响比中低度近视大而且持续时间长,但最终可随着角膜的愈合而恢复。     

Disposable eyelid-warming device for the treatment of meibomian gland dysfunction

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.     

角膜移植治疗Terrien边缘角膜变性

目的 探讨角膜移植治疗Terrien边缘角膜变性的临床效果与安全性.方法 采用非随机回顾性系列病例研究.分析1995年1月至2004年12月期间在中山大学中山眼科中心行病灶切除联合角膜移植手术治疗的40例(48只眼)Terrien边缘角膜变性患者的临床资料,对其中9只眼进行手术前后的散瞳检影验光检查,对7只眼进行手术前后Orbscan Ⅱ角膜地形图检查.结果 患者年龄(30±6)岁,术后随访时间为(7±6)年.手术前、后各参数采用(Q25,Q75)表示.患眼手术前裸眼视力为(0.05,0.4),最佳矫正视力为(0.1,0.5),手术后裸眼视力为(0.2,0.6),最佳矫正视力为(0.4,0.7)(z=4.63,3.85;P均＜0.01).患眼验光球镜度数的术前值为(-2.00 D,-8.50 D),术后值为(-1.25 D,-4.75 D)(Z=2.49,P=0.01);柱镜度数的术前值为(2.50 D,12.00 D),术后值为(0.75 D,4.25 D)(Z=2.54,P=0.01).术后Orbscan Ⅱ角膜地形图模拟角膜曲率、角膜散光度数、角膜直径3 mm与5 mm处的散光度数和屈光力度数均较术前有所下降,除角膜直径5 mm处的散光度数改善外(Z=1.86,P=0.06),其余指标的改善差异均有统计学意义(P＜0.05).手术并发症包括术中植床穿孔5只眼(10.4%)、术后角膜层间积液8只眼(16.7%)、角膜层间上皮植入4只眼(8.3%)、脉络膜脱离1只眼(2.1%)、术后植片排斥反应7只眼(14.6%)、复发3只眼(6.3%).5只眼(10.4%)分别因层间积液、层间上皮植入及复发行二次手术治疗.结论 病灶切除联合角膜移植是Terrien边缘角膜变性的优选治疗手段之一,可有效地保存或提高患眼视力.     

Long-term post trabeculectomy intraocular pressures.

Eighty-one eyes which had had trabeculectomy with a mean follow-up period of 9.2 years (range 7 to 10 years) were studied retrospectively for their subsequent pattern of intraocular pressure. Of 43 chronic open-angle glaucoma eyes, 29 (67%) had their pressures maintained below 21 mmHg by trabeculectomy alone over a 7-10-year period. On the other hand, 25 of 38 (65%) eyes with other types of glaucoma required an average of 1.5 different antiglaucoma medications post-op for the control of their intraocular pressures. Fifteen of 69 (22%) phakic eyes required cataract extraction at a mean of 5.1 years post-op. Two of 43 (5%) chronic open-angle glaucoma eyes suffered blinding complications attributable to the procedure. Seventeen percent: of eyes gained visual field at a mean of 7% of the pre-op field per year following trabeculectomy. Fifty percent lost field at a mean rate of 2.3% per year.     

Scleral dellen after bilateral adjustable suture medial rectus muscle resection.

Ocular complications after strabismus surgery in a large study population were recently reported. The most frequent of these complications included pseudoptosis, corneal dellen, conjunctival folds, and punctate epithelial keratopathy. We report the occurrence of a rare complication, scleral dellen, occurring in a healthy 30-year-old man after bilateral adjustable suture medial rectus muscle resection for residual exotropia.     

糖尿病患者玻璃体切除术中不同角膜保护剂对眼表的影响

目的:探讨糖尿病患者玻璃体切除术中使用不同角膜保护剂对眼表的影响。方法:将2019-01/2020-01本院拟行玻璃体切除术的糖尿病患者90例90眼随机分为HPMC组、SHSCS组和BSS组,各30例30眼,HPMC组和SHSCS组术中分别使用羟丙基甲基纤维素(HPMC)和透明质酸钠-硫酸软骨素钠(SHSCS)覆盖角膜表面避免角膜干燥,BSS组术中使用平衡盐溶液(BSS)不断滴眼保持角膜湿润。手术前后分别行泪液分泌试验(SⅠt)和泪膜破裂时间(BUT)检查,并测量角膜中央厚度,观察对比其变化情况。结果:术后1wk,1mo,BSS组相比HPMC组、SHSCS组,SⅠt明显增加,BUT明显缩短(均P<0.05);术后1wk,HPMC组相比SHSCS组BUT明显缩短(P<0.05);术后3mo,三组患者SⅠt、BUT较术前均无明显差异(P>0.05)。术后第1d,BSS组相比HPMC组、SHSCS组角膜中央厚度明显增加(均P<0.05);术后1wk,三组患者角膜中央厚度较术前均无明显差异(P>0.05)。结论:糖尿病患者行玻璃体切除术中使用HPMC、SHSCS均可以保护角膜,维持泪膜的稳定性,临床上可以根据实际情况选择不同的角膜保护剂。     

结膜松弛症手术前后眼表泪液动力学的变化

目的探讨结膜松弛症（CCh）患者眼表泪液特征及手术前后的变化。方法对Ⅲ级以上A组单纯CCh患者11例（21眼）和B组伴有水性泪液缺乏的CCh患者4例（6眼）进行结膜半月形切除,检测手术前后的临床症状、泪河线高度及形态、泪膜破裂时间（BUT）、SchirmerⅠ试验、荧光素活体染色（FL）、氯霉素尝味试验,并进行比较。结果术前两组患者的主要临床症状均有刺激感或异物感、视物模糊及分泌物增多,干涩、泪溢是A组患者的常见症状,泪河线均异常,氯霉素尝味试验大部分异常,BUT、FL评分均明显异常,B组SchirmerⅠ试验异常。手术后3个月A组各症状及B组刺激感或异物感症状明显改善（P〈0．05）,BUT、FL评分两组均改善（P〈0．05）,A组泪河线及氯霉素尝味试验大部分恢复正常（P〈0．01）,B组无变化,但泪河线形态恢复;两组SchirmerⅠ试验无变化。结论CCh明显影响眼表泪液,松弛结膜新月形切除能缓解或消除CCh的临床症状及眼表损害。     

带角膜缘干细胞的自体结膜瓣移植术对翼状胬肉患者泪膜稳定性的影响

目的:探讨带角膜缘干细胞的自体结膜瓣移植术对翼状胬肉患者干眼及泪膜稳定性的分析。方法:选择114例138眼翼状胬肉患者,根据治疗方式不同分为传统组56例67眼,试验组58例71眼,观察两组术前、术后1、3mo的SⅠt值、BUT值、FL值以及术后两组患者眼球表面温度及干眼症评分。结果:传统组总有效率83.6%,试验组总有效率95.8%,两组有差异(χ2=5.207,P=0.022);两组术前SⅠt值无差异(P>0.05),试验组术后1、3mo SⅠt值较传统组升高更为显著(均P<0.05);传统组、试验组术前BUT值无差异(P>0.05),术后1、3mo试验组BUT值较传统组明显增加(均P<0.05);传统组、试验组术前FL分值无差异(P>0.05),试验组术后1、3mo FL值较传统组有所降低(均P<0.001);传统组、试验组眼球表面温度无差异(P>0.05),干眼症评分试验组明显低于传统组(P<0.05)。结论:采用带角膜缘干细胞的自体结膜瓣移植术疗效优于行翼状胬肉切除联合羊膜移植术,可促进翼状胬肉患者泪膜稳定性恢复,患者干眼症状有明显改善。     

结膜松弛症定量定位切除术的临床疗效观察

目的:为了寻求安全、简便、经济、有效切除结膜松弛症的手术方法,评价结膜松弛症定量定位切除术和新月形切除术的临床疗效。方法:采用前瞻性随机分组对照研究方法,将2008-01/2009-05在上海中医药大学附属普陀医院眼科按照结膜松弛症诊断标准入选手术治疗患者30例30眼按患者入选编号末位数的奇偶数随机分为两组。奇数组行结膜定量定位切除术15例15眼;偶数组行结膜新月形切除术手术15例15眼。手术后第2,4,8wk分别随访患者症状改善程度,裂隙灯观察结膜松弛症变化情况,测量泪河、BUT,氯霉素眼液尝味试验。结果:结膜松弛症定量定位切除仪和结膜新月形切除术组术后4wk,两组症状改善有效率均为87%,无差异。结膜定量定位切除术松弛结膜完全消除,占87%;结膜新月形切除术组松弛结膜完全消除,占73%,差异无统计学意义(χ2=0.833,P=0.361)。结膜定量定位切除术后4wk泪河恢复正常者,占87%,BUT≥10s者,占73%,氯霉素眼液尝味试验阳性者,占53%。结膜新月形切除术后4wk泪河恢复正常者,占73%(χ2=0.833,P=0.361),BUT≥10s者,占67%(χ2=0.159,P=0.690),氯霉素眼液尝味试验阳性者,占60%(χ2=0.136,P=0.713),差异均无统计学意义。结论:结膜松弛症定量定位切除术安全、简便、准确、有效,更适合手术经验不足的医师开展。