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。

Effect of preoperative intervention on ocular surface recovery after trabeculectomy

Objective　To evaluate the effect of 3 g·L^-1 sodium hyaluronate eye drops on the recovery of ocular surface function after trabeculectomy when applied preoperatively.Methods　In this prospective case-control study, sixty-three eyes of fifty-two patients with primary chronic angle-closure glaucoma or primary open-angle glaucoma who were hospitalized in our hospital from January 2017 to March 2018 for trabeculectomy were selected and sorted into intervention group and control group. The intervention group was given 3 g·L^-1 sodium hyaluronate eye drops 1 week before operation, and the observation group was given 3 g·L^-1 sodium hyaluronate eye drops 1 day after operation. Basic conditions of the two groups were matched before operation. The ocular surface disease index, corneal fluorescein sodium staining score (OSDI), tear film break-up time (BUT) and tear secretion test were compared between the two groups one week, one month and three months after operation.Results　Both groups had different degrees of dry eye symptoms and signs before operation. Dry eye conditions were worse one week after operation in both groups, especially in the control group, presenting that OSDI score and corneal fluorescence staining score were higher than those before operation, BUT were shorter than those before operation (all P<0.05). One month after operation, the OSDI score, corneal fluorescence staining score and BUT were (14.43±5.33) points, (0.71±0.56) points, (8.65±3.01) s , which were better than the control group ［(22.08 ± 6.71) points, (1.38 ± 0.88) points, (7.12 ± 2.98) s, respectively］, and the differences are statistically significant (all P<0.01). There were no significant differences in each index between two groups at 3 months after operation (all P>0.05).Conclusion　Preoperative application of 3 g·L^-1 sodium hyaluronate eye drops can effectively prevent or alleviate postoperative ocular surface damage, shorten the ocular surface damage recovery time, and relieve patients’ dry eye symptoms.