结膜松弛症新月形切除术临床疗效观察

Observation of the curative effect of crescent-shaped conjunctiva resection

目的为了寻求安全、简便、经济、有效治疗结膜松弛症的方法 ,评价结膜松弛症结膜新月形切除术的临床疗效。方法采用前瞻性研究方法 ,对结膜松弛症患者15例(30眼)行结膜新月形切除术。术后第2、4、8周随访患者症状改善程度,裂隙灯观察结膜松弛切除程度、手术切口愈合情况、手术并发症评价、测量泪河、泪膜破裂时间及氯霉素眼液尝味试验。结果术后4周国际眼表面疾病指数明显降低,术后8周趋于稳定,与术前比较,差异有统计学意义(t=6.743,P=0.000)。术后2、4、8周泪河明显改善,术后8周25眼泪河恢复正常。术后8周泪膜破裂时间≥10s有18眼,与术前比较差异有统计学意义(χ2=8.297,P=0.004)。术后8周,氯霉素眼液尝味试验阳性率为46.6%(14/30)。松弛结膜残留积分术后2周10分,4周7分,8周6分。手术并发症积分术后2周6分,4周12分,8周8分。结论球结膜新月形切除术治疗结膜松弛症安全、有效,明显改善结膜松弛症症状。

Objective To estimate the curative effect after crescent-shaped conjunctiva resection and pharmacotherapy for finding a safe and effective treatment for conjunctivochalasis. Methods Fifteen patients（30 eyes） with conjunctivochalasis were treated by crescent-shaped conjunctiva resection in this study. The patients underwent system check including objective feeling with Ocular Surface Disease Index （OSDI） slit lamp observation for the residual conjunctiva and the wound healing, operation complications ,break-up time （BUT） ,measurement of lacrimal river and chloroptic tas- ting test after 2, 4 and 8 weeks of treatment. Results The OSDI points became obviously lower 4 weeks after crescent- shaped conjunctiva resection, and stable 8 weeks postoperation. The difference has statistical significance（t = 6. 743 ,P = 0.000）. The lacrimal river of 25 eyes improved after operation, and BUTs became normal in 18 eyes of this study after 8 weeks（ X2= 8. 297 ,P =0.004）. The chloroptic tasting test of 14 eyes （46.6%） was positive in operation cases after 8 weeks. Residual score of postoperative conjunctiva was 10 after 2 weeks, 7 for 4 weeks and 6 for 8 weeks. Operation complication score was 6 after 2 weeks, 12 for 4 weeks and 8 for 8 weeks. Conclusions Crescent-shaped conjunctiva re- section for treating conjunctivochalasis could be safe and effective.