离休干部结膜松弛症患病调查

Conjunctivochalasis survey among retired cadres

目的:结膜松弛症是老年人常见眼病,为此对离休干部进行结膜松弛症患病调查,探讨结膜松弛症发病机制,寻求有效治疗方法。方法:对上海市普陀区离休干部278例(556眼)年龄69～96(平均81.05)岁,对照结膜松弛症的诊断及分级标准将下睑缘位置分为三型:角膜缘下型、角膜缘型、角膜缘上型;下眼睑张力分为五型:下睑缘内翻型、下睑缘内倾型、下睑缘正常型、下睑缘外倾型、下睑缘外翻型。由专人专职进行松弛结膜、下睑缘位置、下睑缘张力的检查并进行统计分析。结果:有254例(496眼)患有结膜松弛症,占89.2%,其中I级133例(262眼)占47.1%,II级110例(215眼)占38.7%,III、IV级共17例(19眼)占3.4%。结膜松弛症患者中下睑缘位置为角膜缘型最多(143例283眼,占57.1%);其次为角膜缘上型(74例142眼,占28.6%);角膜缘下型最少(41例71眼,占14.3%)。结膜松弛症患者中下睑缘张力为下睑缘正常型114例(224眼),占45.2%;下睑缘内倾型多于(84例147眼,占29.6%)下睑缘外倾型(41例80眼,占16.1%);下睑缘内翻型较少(2例45眼,占9.1%)。本组病例未发现下睑缘外翻型。下睑缘内翻型、内倾型发生结膜松弛症的概率比正常型要高,有显著性差异(P=0.0001)。结论:老年人结膜松弛症发病率较高,下睑缘张力高是结膜松弛症发生因素之一。

AIM： Conjunctivochalasis is a common ocular disease in elders. A survey of conjunctivochalasis among retired cadres was carried out to further understand the mechanism and to find effective treatment.METHODS： A total of 278 retired cadres （556 eyes） in Shanghai Putuo district were recruited in the investigation. Their age ranged 69-96 years （mean 81.05 years）. Based on the criteria of conjunctivochalasis diagnosis and classification, patients can be subgrouped into 3 types according to the position of inferior plapebral margin： below corneal limbus, corneal limbus and above corneal limbus. Patients can be subdivided into 5 types according to the tension of lower eyelid： inferior palpebral margin varus, inferior palpebral margin inclining inward, normal inferior palpebral margin, inferior palpebral margin inclining outward, inferior palebral margin valgus. Conjunctivochalasis examination, palpebral margin position examination and lower eyelid tension examination were all performed by special ophthalmologic staff and statistical analysis was made. RESULTS： There were 254 cases （496 eyes） who had conjunctivochalasis, occupying 89. 2%. Among these patients, 133 cases （262 eyes） were grade I （47.1%）; 110 cases （215 eyes） were grade 11（38.7%） ; 17 cases （19 eyes） belonged to grade Ⅲ and grade IV （3.4%）. Majority of conjunctivochalasis patients were type of corneal limbus in terms of the position of inferior palpebral margin （14.3 cases, 283 eyes, 57.1%）; type of above corneal limbus came next （74 cases, 142 eyes, 28.6%）; type of below corneal limbus took the third （41 cases, 71 eyes, 14.3%）. There was no significant difference between three types.With regard to the tension of inferior palpebral margin, there were 114 cases （224 eyes） of normal inferior palpebral margin, constituting 45.2%; there were more inferior palpebral margin inclining inward （84 cases, 147 eyes, 29.6%） than inferior palpebral margin inclining outward （41 cases, 80 eyes, 16.1%）; there were fewer patients of inferior palpebral margin varus （24 cases, 45 eyes, 9. 1%）; no cases were found inferior palpebral margin valgus. The probability of conjunctivochalasis incidence in inferior palpebral margin varus type and inclining inward type was significantly higher than normal type （P=0.0001）.CONCLUSION： The incidence of conjunctivochalasis was high in elders, and high tension of inferior palpebral margin was one of pathogenic factors.