不同方式斜视手术前后泪膜的变化

Tear film changes after different style of strabismus surgery

目的观察不同方式斜视手术前后泪膜的变化，分析其对泪膜功能的影响。方法将113例（203眼）斜视患者分为A组（98例，手术眼行单条眼外肌手术）和B组（105例，手术眼行2条或3条眼外肌手术），分别观察手术前和手术后3d、1周、2周、4周时基础泪液分泌试验（SIt）、泪膜破裂时间（BUT）和角膜荧光素评分的变化。结果两组患者术前1d的各项泪膜功能检查结果比较差异无统计学意义。与术前相比，手术后各时间点两组患者的SIt变化均无统计学意义。A组患者BUT在术后3d时明显缩短，直至术后2周时恢复正常；角膜荧光素评分则在术后3d时明显升高，但于术后l周检查时已下降至术前状态。B组患者BUT在术后3d时明显缩短，直至术后4周时恢复正常；角膜荧光素评分则在术后3d时明显升高，于术后2周检查时才下降至术前状态。结论减少单眼手术操作，缩短单眼手术时间，可减少手术对泪膜功能的影响。

Objective To observe the tear film changes after different style of strabismus surgery. Methods One hundred and thirteen patients （203 eyes） were divided into group A （98 cases, single extraocular muscle surgery in one eye） and group B （ 105 cases, 2 or 3 extraocular muscles surgery in one eye）. Schirmer I test（SIt）, breakup time （BUT）and fluorescence integral（FI）were observed preoperatively and 3 days, 1 week, 2 weeks and 4 weeks postoperatively. Results There were no significant difference in S I t, BUT and FI between group A and group B at 1 day preoperatively. The changes of S I t postoperatively were no statistically significant comparing with preoperative. BUT reduced significantly at 3 days postoperatively and recovered at 2 weeks postoperatively in group A, FI increased significantly at 3 days postoperatively and recovered at 1 weeks postoperatively in group A. On the other hand, BUT reduced significantly at 3 days postoperatively and recovered at 4 weeks postoperatively in group B, FI increased significantly at 3 days postoperatively and recovered at 2 weeks postoperatively in group B. Conclusions Reduce procedure on single eye, shortern operation time on single eye, could reduce the impact of tear film function.