纤维蛋白胶封闭泪道治疗干眼症的临床观察

Clinical Observation on Treatment of Dry Eye Syndrome with Fibrin Glue for Obstructing Lacrimal Canal

目的：探讨纤维蛋白胶下泪点注入封闭泪道治疗干眼症的方法和临床疗效。方法：对15例（30只眼）顽固干眼患者行裂隙灯下自下泪点注入纤维蛋白胶0.1ml,以部分性封闭泪道,分别于治疗前3天及治疗后3天、1周、2周、3周行干眼问卷评分、角膜荧光素染色、泪膜破裂时间（BUT）及SchirmerⅠ试验（STI）检查,记录结果。结果：治疗后1周内所有患者干眼相关症状均得到不同程度的缓解,裂隙灯检查泪河高度均较术前提高,1周后所有患者荧光素染色角膜上皮点状着色情况均较术前明显改善,BUT和STI检查结果均较术前明显延长和增加。3周复诊时,大部分患者症状有所反复,BUT和STI检查结果再次下降,下泪点进针冲洗泪道均通畅。结论：使用纤维蛋白胶下泪点注入封闭泪道的治疗方法可以在短期内改善干眼患者的临床症状,增加患者眼球表面泪液量,改善泪膜稳定性。治疗方法安全可靠,简单易行,患者经济负担轻,且治疗后2-3周时泪道可自行通畅,治疗可逆。纤维蛋白胶封闭泪道可作为替代可降解型泪道栓子用于干眼患者的治疗。

Objective： To observe the methods and clinical efficacy of treating dry eye syndrome with fibrin glue for obstructing lacrimal canal. Methods： Fibrin glue was injected into inferior lacrimal canal in 15 patients （30 eyes） with refractory dry eye in our clinic. Questionnaire was used in these patients before the surgery 3 days and repeated after surgery 1 week, 2 weeks and 3 weeks. Slit lamp microscope examination, fluorescent staining for tear break - up time （BUT） , Schirmer test Ⅰ （ ST Ⅰ） were carried out at the same time. Results： After treatment, all patients＇ dry eye related symptdms were relieved obviously in 1 week. Compared with pre - operation, tear production was increased significantly on the surface of eyes and the defect of corneal epithelium was improved. BUT and ST I were increased and elongated on these patients. Conclusions： Symptoms of patients suffered from dry eye can be relieved obviously by using fibrin glue for obstructing lacrimal canal in the short term. The tear volume and tear film stability can be improved. The treatment is safe, reliable, simple and reversible. The financial burden of patients with light. The use of fibrin glue for obstructing lacrimal canal is an alternative treatment for dry eye patients besides of biodegradable lacrimal plugs.