不同方式斜视手术前后泪膜的变化

目的观察不同方式斜视手术前后泪膜的变化，分析其对泪膜功能的影响。方法将113例（203眼）斜视患者分为A组（98例，手术眼行单条眼外肌手术）和B组（105例，手术眼行2条或3条眼外肌手术），分别观察手术前和手术后3d、1周、2周、4周时基础泪液分泌试验（SIt）、泪膜破裂时间（BUT）和角膜荧光素评分的变化。结果两组患者术前1d的各项泪膜功能检查结果比较差异无统计学意义。与术前相比，手术后各时间点两组患者的SIt变化均无统计学意义。A组患者BUT在术后3d时明显缩短，直至术后2周时恢复正常；角膜荧光素评分则在术后3d时明显升高，但于术后l周检查时已下降至术前状态。B组患者BUT在术后3d时明显缩短，直至术后4周时恢复正常；角膜荧光素评分则在术后3d时明显升高，于术后2周检查时才下降至术前状态。结论减少单眼手术操作，缩短单眼手术时间，可减少手术对泪膜功能的影响。

Tear film changes after different style of strabismus surgery

Objective To observe the tear film changes after different style of strabismus surgery. Methods One hundred and thirteen patients （203 eyes） were divided into group A （98 cases, single extraocular muscle surgery in one eye） and group B （ 105 cases, 2 or 3 extraocular muscles surgery in one eye）. Schirmer I test（SIt）, breakup time （BUT）and fluorescence integral（FI）were observed preoperatively and 3 days, 1 week, 2 weeks and 4 weeks postoperatively. Results There were no significant difference in S I t, BUT and FI between group A and group B at 1 day preoperatively. The changes of S I t postoperatively were no statistically significant comparing with preoperative. BUT reduced significantly at 3 days postoperatively and recovered at 2 weeks postoperatively in group A, FI increased significantly at 3 days postoperatively and recovered at 1 weeks postoperatively in group A. On the other hand, BUT reduced significantly at 3 days postoperatively and recovered at 4 weeks postoperatively in group B, FI increased significantly at 3 days postoperatively and recovered at 2 weeks postoperatively in group B. Conclusions Reduce procedure on single eye, shortern operation time on single eye, could reduce the impact of tear film function.