结膜松弛综合征的临床研究

A clinical study of conjunctivochalasis

目的观察球结膜松弛的临床症状,探索保守治疗和手术治疗的效果。方法选择30例(58只眼) 球结膜松弛并有泪溢或干眼等症状的患者系统观察,进行症状评估、泪河观察、BUT测定、眼表荧光素染色,并观察手术后球结膜及下睑缘变化。32只眼由于轻度球结膜松弛及干眼症状,局部给予0．1％爱丽滴眼液缓解症状; 26只眼中重度球结膜松弛引起泪溢,经手术解除泪溢。随访2-4月。结果32只眼给予0．1％爱丽滴眼液干眼症状改善者26只眼(81．25％);BUT≥10秒者29只眼(90．63％);眼表荧光素染色正常者24只眼(75．00％)。26 只眼手术后泪溢症状改善者22只眼(84．62％),BUT≥10秒者18只眼(69．23％);眼表荧光素染色正常者19只眼 (73．08％);裂隙灯显微镜检查眼球与下睑缘、内、外眦部之间无松弛结膜皱褶者20只眼(76．92％);下睑缘位置正常者23只眼(88．46％);泪河恢复正常者21只眼(80．77％)。结论选择适宜治疗方式治疗结膜松弛症是安全、有效的。

Objective To investigate the clinical symptom of conjunctivochalasis and the effect of surgical treatment and drug therapy. Methods 30 patients （58 eyes） with epiphora and dry eye were studied. The evaluation was based on： symptom evaluation, Tear meniscus, BUT test, bulbar oculi fluorescein staining and post-operation observation of bulbar eonjunetival/lip-margin inferior changing. 32 dry eyes caused by the Tear film instability by low-grade eonjunetival laxity were treated by 0.1% Hialid drop. 26 epiphora eyes caused by interference of lower tear meniscus formation and the occlusion of the inferior puncture by middle and severity-grade eonjunetival laxity, they are refractory to drug therapy and must therefore be treated surgically. In the case with the follow-up range 2～4 months. Results In 32 dry eyes symptom improved in 26 eyes （81.25%） ; BUT≥10 seconds in 29 eyes （90.63%） ;19 eyes with normal bulbus oculi fluoreseain staining result （75.00%） ; no ehalasis fold between bulbus oculi and lip-margin inferior, inner/outer canthus was found in 20 eyes （76.92%） ; 23 eyes （88.46%） were with normal lip-margin inferior position. Normal Tear meniscus reformed in 21 eyes （ 80.77% ）. Conclusion Conjunctivochalasis with appropriate selected method is safe and effective.