硅油取出术对泪膜稳定性的影响

Studies on tear film stability after silicone oil removal

目的探讨硅油取出术对眼表泪膜稳定性的影响。方法在无全身及其他眼部疾病并因视网膜脱离行闭合式玻璃体切割联合硅油填充手术的患者中,抽取年龄在20～40岁单纯行硅油取出术的患者20例20眼,分别于术前、术后1d、术后7d、术后14d、术后30d、术后90d行基础泪液分泌试验(schimmer I test,SIT)、泪膜破裂时间(break up time,BUT)、角膜荧光素染色(corneal fluorescein staining,CFS)检查。结果术前SIT、CSF、BUT分别为(12.55±1.36)mm、2.23±2.10、(10.61±2.35)s;与术前相比,术后1d、7d、14dSIT分泌量明显增加[(25.10±1.41)mm、(20.30±1.84)mm、(15.25±1.83)mm],CFS着色点明显增多(5.20±3.08、5.33±2.95、4.38±2.92),BUT[(5.08±1.59)s、(5.58±1.48)s、(6.29±1.68)s]明显缩短,差异均有统计学意义(均为P<0.05);术后30dSIT分泌量(11.90±1.45)mm、CFS着色点2.40±2.33与术前相比差异均无统计学意义(均为P>0.05),BUT(7.03±2.02)s差异有统计学意义(P<0.05);术后90dSIT分泌量、CFS着色点、BUT与术前相比差异均无统计学意义(均为P>0.05)。结论硅油取出术可影响术眼泪膜的稳定性,术后90d方可恢复到术前水平。

Objective To investigate the effect of silicone oil removal on tear film stability.Methods In patients without systemic disease or ocular disease and treated with closed vitrectomy and silicone oil padding induced by detachment retina,20 patients（20 eyes） aged from 20 to 40 were enrolled and underwent silicone oil removal.Tear beak up time （BIT）,Schirmer I test（SIT） value and corneal fluorescein staining 9csf） were measured preoperatively and at postoperative 1 day,7 days,14 days,30 days and 90 days,respectively.Results SIT,CSF and BUT were （12.55±1.36）mm,2.23±2.10 and （1.61±2.35）s preoperatively.Compared with preoperative results,SIT significantly increased and were （25.10±1.41）mm,（20.30±1.84）mm and （15.25±1.83）mm at postoperative 1 day,7 days and 14 days,CFS obviously increased and were 5.20±3.08,5.33±2.95 and 4.38±2.92,BUT obviously decreased and were （5.08±1.59）s,（5.58±1.48）s and （6.29±1.68）s （all P〈0.05）.At postoperative 30 days,SIT was （11.90±1.45）mm,CFS was 2.40±2.33 and BUT was （7.03±2.02）s.Compared with preoperative results,no difference was found in SIT or CFS（P〉0.05）,but significant in BUT（P〈0.05） at postoperative 30 days,no significant difference was found in SIT,CFS or BUT at postoperative 90 days（all P〉0.05）.Conclusions Silicone oil removal alters the stability of tear film.The tear film function returned to preoperative conditions at postoperative 90 days.