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目的探讨瞬目征儿童的角膜前表面相关变化及人工泪液对瞬目征儿童角膜前表面的影响。方法应用ZEISS公司的Humphrey ALTAS Corneal Topography System角膜地形图仪检测排除眼部诱因特有异常瞬目的抽动症儿童35例(70只眼)的形状系数(shape factor,SF)、角膜不规则值(corneal irregular measure,CIM)和Simk两个正交子午线曲率值;随访至瞬目征好转(17例34只眼人工泪液点眼,18例36只眼未行人工泪液点眼),记录SF、CIM、Simk两个正交子午线曲率值及治疗天数,全部数据作t检验。结果瞬目征儿童的形状系数(SF)、角膜不规则值(CIM)和Simk两个正交子午线曲率值分别为0.413±0.204,1.409±0.995及Kh=43.542±1.254,Kv=42.581±1.045。瞬目征儿童的CIM值较正常人(0.03~0.68)明显升高。瞬目征好转患者CIM、SF、Kh、Kv均明显减小(P<0.05,差异有显著性)。瞬目征好转用人工泪液患者CIM值较未用药患者减小(P<0.05,差异有显著性),SF、Kh、Kv无明显差异(P>0.05),用药与未用药患者病程有显著差异,其中用药患者病程明显缩短(P<0.05)。结论瞬目征儿童的角膜存在一定的不规则性;角膜地形图检查可以进行判断,特别是CIM数值;人工泪液治疗可以改善异常瞬目体征和缩短异常瞬目体征好转的疗程。
Objective To investigate the changes of corneal anterior surface in children with blink symptoms and the effect of artificial tears on the anterior corneal surface of children with blink symptoms. Methods The shape factor (SF), corneal irregularity (corneal irregularity) of 35 children (70 eyes) with twitch eye abnormalities were detected by ZEISS Humphrey ALTAS Corneal Topography System corneal topography. Measurements (CIM) and Simk were used to measure the curvature of the two orthogonal meridians. Fourteen eyes (17 eyes of 17 eyes with artificial tears and 18 eyes of 36 eyes without artificial tears) were followed up, and SF, CIM and Simk were recorded Orthogonal meridian curvature and treatment days, all data for t test. Results The shape factor (SF), curvilinear irregularity (CIM) and Simk two orthogonal meridian curvature values of children with blink symptoms were 0.413 ± 0.204, 1.409 ± 0.995 and Kh = 43.542 ± 1.254, respectively. Kv = 42.581 ± 1.045. Children with blink symptoms CIM values were significantly higher than normal (0.03 ~ 0.68) was significantly higher. CIM, SF, Kh and Kv were significantly decreased in patients with improvement of blink symptoms (P <0.05, the difference was significant). There was no significant difference in SF, Kh, Kv (P> 0.05) between the patients with blink symptoms and the patients without medication (P <0.05, the difference was significant) Among them, the duration of treatment was significantly shorter (P <0.05). Conclusions There is some irregularity in the cornea of children with blinking symptoms. Corneal topography can be used to judge the value of CIM, especially the CIM value. Artificial tear treatment can improve abnormal blink signs and shorten the course of abnormal blink signs.