斜视手术不同切口对泪膜功能的影响

Changes in Function of the Tear Film after Atrabismus Surgery with Different Incisions

目的探讨斜视手术不同位置切口对泪膜功能的影响。方法根据手术切口位置不同将50例斜视手术患者分为鼻侧切口组、颞侧切口组和双侧切口组,于术前及术后3 d行泪液分泌及泪膜破裂时间(BUT)检查,并对3组患者的泪膜功能进行比较。结果与术前相比,斜视手术后泪液分泌量及泪膜稳定性下降(P<0.05);不同切口组术前与术后3 d泪液分泌量无明显差异(P>0.05);鼻侧切口组术前与术后3 d BUT的差值与颞侧切口组比较,差异有统计学意义(P<0.05),而与双侧切口组相比差异无统计学意义(P>0.05),双侧切口组与颞侧切口组之间差异有统计学意义(P<0.05)。结论斜视手术后泪液分泌量减少,BUT缩短。鼻侧切口斜视手术对泪膜稳定性的影响较大。

Objective To study the changes in function of the tear film after awabismus surgery, and the relationship between changes of the function of tear film and the operation program. Methods Schirmer I test and break up time （BUT） of tear film were performed on fifty hospitalized patients with strabismus from September 2010 to September 2011 in the First Hospital of China Medical University. The pa- tients were divided into 3 groups by different conjunctival incisions：nosal conjunctival incision, bitamporal conjunctival incision and bilateral conjunctival incision, then the function changes of tear film were analyzed. Results Comparing with preoperative, Schirmer I test and BUT were significantly reduced. Comparing with bitamporal conjunctival incision, there is no significant difference of Sehinner I test but a signifi- cant decrease of BUT in nosal conjunctival incision. Comparing with bilateral conjunctival incision,there is no significant difference of Schirmer I test or BUT in nosal conjunctival incision. Conclusion The strabismus surgery can significantly change the function of the tear film, the conjunctival incision in nosal conjunctival has a great impact on the tear fdm stability.