角膜移植术后泪膜稳定性的初步研究

目的探讨角膜移植术后6m-12m内泪膜的稳定性。方法对22例行部分穿透性角膜移植术的患者,术后6m-12m内进行随访,双眼均做系统检查,并检测双眼泪膜破裂时间、泪液分泌值及角膜荧光素染色。本文采用t检验的方法,将患者的术眼和健眼所测得的数据进行比较。结果当无角膜移植排斥反应发生时,术眼泪膜破裂时间仍低于健眼(P<0.05),但患者无明显眼部干涩等症状;泪液分泌值与健眼相比无显著差异;荧光素染色,3例角膜植片有点状着色。当发生排斥发应时,术眼泪膜破裂时间为0;术眼泪液分泌值明显高于正常眼;荧光素染色,角膜植片弥漫性着色。结论1.角膜移植术后6m-12m的时间内,术眼的泪膜稳定性仍未恢复到正常水平,当发生排斥反应时,泪膜的稳定性更下降。2.建议术后6m-12m的时间内,可依据术眼情况而使用人工泪液,继续使用角膜营养药物及神经营养药物。3.应定期复查眼部情况,以及早发现眼部的病变。4.不同的缝合方式对术后泪膜稳定性的影响无明显差异。目的探讨角膜移植术后6m-12m内泪膜的稳定性。方法对22例行部分穿透性角膜移植术的患者,术后6m-12m内进行随访,双眼均做系统检查,并检测双眼泪膜破裂时间、泪液分泌值及角膜荧光素染色。本文采用t检验的方法,将患者的术眼和健眼所测得的数据进行比较。结果当无角膜移植排斥反应发生时,术眼泪膜破裂时间仍低于健眼(P<0.05),但患者无明显眼部干涩等症状;泪液分泌值与健眼相比无显著差异;荧光素染色,3例角膜植片有点状着色。当发生排斥发应时,术眼泪膜破裂时间为0;术眼泪液分泌值明显高于正常眼;荧光素染色,角膜植片弥漫性着色。结论1.角膜移植术后6m-12m的时间内,术眼的泪膜稳定性仍未恢复到正常水平,当发生排斥反应时,泪膜的稳定性更下降。2.建议术后6m-12m的时间内,可依据术眼情况而使用人工泪液,继续使用角膜营养药物及神经营养药物。3.应定期复查眼部情况,以及早发现眼部的病变。4.不同的缝合方式对术后泪膜稳定性的影响无明显差异。

Primary Research on the Tear Film Stability after Penetrating Keratoplasty

Objective To observe the tear film stability during the time from six months to twelve months after penetrating keratoplasty. Methods Twenty-two cases (22 eyes) , during the time from six months to twelve months after penetrating keratoplasty , were examined. We observed two eyes of each patient, includ- ing vision, Schirmer Test I with anaesthesia, tear film break-up time and corneal fluorescein staining. We use statistics analysis to compare the data we gained of the healthy eye with the data of the operative eye of the same patient. Results When there is no corneal graft rejection, the data of tear film break-up time of the operative eye was still less than the healthy eye (P<0.5), But the patients didn't feel dull and dry; the data of Schirmer Test I with anaesthesia of the operative eye was equal to the healthy eye; and corneal fluorescein staining was punc- tate with three patients. The data of tear film break-up time of the operative eye was 0 with corneal graft rejection; the data of Schirmer Test I with anaesthesia of the operative eye was higher evidently than the healthy eye; and corneal fluorescein staining was spread. Conclusion 1. During the time from six months to twelve months after penetrating keratoplasty, the tear film stability does not get resume,and declines with corneal graft rejection, yet. 2. After operated six months,we can use manual tear depending on the state of the operative eye, and continue medication with corneal nutrition and nerve nutrition. 3. Patien still should examine eye regularity to detection the process early. 4. Different suture mode does not effect the tear film stability.