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目的探讨显微斜视手术对泪膜稳定性的影响,了解泪膜稳定性的变化与手术方式之间的关系。方法随机抽取2006年5月至2007年10月我院住院的斜视患者120例212眼,分2组。A:常规结膜切口52例(90眼);B:微创结膜切口68例(122眼)。检测术前1d,术后1d、3d、5d、7d、14d的基础泪液分泌试验(Sehirmer I test,SIt)、泪膜破裂时间(break up time,BUT)及角膜荧光素染色积分(nuoreseenee integral,FI),并对其泪膜稳定性的变化进行分析。结果与术前相比,常规结膜切口组术后1d SIt和角膜荧光素染色程度明显增高,BUT明显缩短,差异有显著意义;7d时SIt,14d时BUT、角膜荧光素染色积分恢复至术前水平。微创结膜切口组术后1d仅SIt明显增高,BUT明显缩短,角膜荧光素染色积分无明显变化。术后5d时SIt,7d时BUT恢复至术前水平。结论常规结膜切口行斜视手术,显著降低泪膜的稳定性,微创结膜切口行斜视手术,轻微影响泪膜的稳定性。
Objective To investigate the effect of microscopic strabismus on the stability of tear film and to understand the relationship between the stability of tear film and the surgical approach. Methods A total of 212 eyes of 120 patients with strabismus admitted to our hospital from May 2006 to October 2007 were randomly divided into 2 groups. A: Conventional conjunctival incision in 52 cases (90 eyes); B: Minimally invasive conjunctiva incision in 68 cases (122 eyes). The basal tear secretion test (Sehirmer I test, BUT) and corneal fluorescein staining integral (numerseenee integral) were performed on the first day before operation and at 1d, 3d, 5d, 7d and 14d after operation. FI), and analyze changes in tear film stability. Results Compared with preoperative, SIt and corneal fluorescein staining were significantly increased in the conventional conjunctival incision group and the BUT was significantly shortened, the difference was significant; on the 7d, the integral of BUT and corneal fluorescein staining returned to preoperative Level. In the minimally invasive conjunctival incision group, the SIt was significantly increased at 1 day after surgery, the BUT was significantly shortened, and the corneal fluorescein staining score had no significant change. At 5 days after operation, the BUT returned to the preoperative level at SIt and 7d. Conclusion Conventional conjunctival incision strabismus surgery, significantly reducing the stability of the tear film, minimally invasive conjunctival incision strabismus operation, a slight impact on the stability of the tear film.