翼状胬肉切除联合生物羊膜移植术后泪膜稳定性研究

Clinical research of tear film stability after pterygium excision with amniotic membrane transplantation

目的:评价翼状胬肉切除联合生物羊膜移植术后泪膜功能的改变。方法:该研究共纳入126例单眼翼状胬肉患者,就诊时间2011-01/2013-11,所有患者均行翼状胬肉切除联合生物羊膜移植术。分别于术前1d;术后1wk;1,2mo行双眼泪膜功能检查,包括泪液分泌试验(SchirmerⅠtest,SⅠt)、泪膜破裂时间(break up time,BUT)、泪液羊齿状物试验(tear ferning test,TFT)。手术眼为研究组,对侧眼为对照组。结果:与对照组相比,研究组术前BUT,TFT均显著异常(P<0.05),SⅠt试验两组之间无显著性差异(P>0.05);研究组术后1mo时BUT,TFT均明显优于术后1wk(P<0.05),与术后2mo相比无显著差异(P>0.05)。研究组术后1wk泪膜稳定性仍低于对照组(P<0.05),术后1,2mo时两组差距不明显(P均>0.05)。SⅠt试验结果显示两组之间各个时间点比较无显著差异(P均>0.05)。结论:翼状胬肉术前存在明显的泪膜稳定性异常;翼状胬肉切除联合生物羊膜移植可以显著改善术后泪膜功能,术后1mo时达到稳态。

AIM： To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.METHODS：Totally 126 patients with pterygium excision with amniotic membrane transplantation from January2011 to November 2013 were entered in the study. The tear breakup time（BUT）,the Schirmer I test（SⅠt） and tear ferning test（ TFT） were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey,1wk,1,2mo after surgery.Operation eyes were studied group, while opposite healthy eyes as control group.RESULTS： Compared with the control group,BUT and TFT were significantly different in the eyes with pterygium（P0.05）; However,no obvious difference was detected in the results of SⅠt（ P〈0. 05）. The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk（P〈0. 05）,while no significant difference compared with 2mo（ P〈0. 05）; The tear film stability in the study group at 1wk after surgery was still inferior to the control group（P〈0. 05） and there was no significant difference at 1,2mo after surgery（ P all 0. 05）. S Ⅰ t results did not differ between the different examinationtimes（P〈0. 05）.CONCLUSION：Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state,and the tear film function could reach steady- state 1mo after surgery.