卡波姆眼用凝胶对下泪河影响的动态观察

Dynamic changes in the lower tear meniscus after instillation of carbomer eye drops

目的比较卡波姆眼用凝胶滴眼后干眼患者组和正常对照组下泪河面积(TMA)和下泪河高度(TMH)的动态变化。方法研究对象为10例(20眼)干眼患者和10例(20眼)性别、年龄匹配的健康对照。研究对象均进行裂隙灯、泪膜破裂时间、泪液分泌实验检查。0.2%卡波姆眼用凝胶1滴滴双眼。使用眼前节相干光断层扫描(OCT)分别在滴眼前和滴眼后1、5、10、15和30 min动态检查TMA和TMH。结果干眼患者组TMA和TMH基线分别为(0.014 9±0.007 5)mm2和(220.200±49.112)μm;健康对照组基线TMA和TMH分别为(0.049 6±0.026 7)mm2和(375.615±121.425)μm,明显较干眼患者组高(P=0.000)。2组的TMA和TMH在滴眼后1 min均显著升高,5 min时仍维持较高水平。但是滴眼后10 min,健康对照组的TMA和TMH即恢复到基线水平,而干眼患者组则在30 min时恢复到基线水平。结论卡波姆眼用凝胶可在短时间内显著提高干眼患者的TMA和TMH。眼前段OCT是动态观察下泪河变化的良好工具。

Objective To observe the effect of instillation of carbomer eye drops on lower tear meniscus area （TMA） and tear meniscus height（TMH） in patients with dry eye.Methods Twenty eyes of 10 patients with dry eye and twenty eyes of 10 age-and sex-matched healthy subjects were included in the study.Slit-lamp microscopy examination,tear film breakup time and Schirmer I testing were performed.The lower TMA and TMH were measured before and 1,5,10,15,and 30 minutes after instillation of a drop 0.2％ carbomer eye drops using anterior segment optical coherence tomography.Results The baseline lower TMA and TMH in the dry eye group were （0.014 9 ± 0.007 5）mm2 and （220.200 ±49.112） μm,which were significantly lower than （0.049 6 ±0.026 7） mm2 and （375.615 ± 121.425）μm in the control group.A significant increase in TMA and TMH was found at 1 minute and 5 minutes after instillation of carbomer eye drops in both groups and they returned to baseline levels at 10 and 30 minutes after instillation in the control group and dry eye group,respectively.Conclusions Carbomer eye drops could provide a significant yet temporary improvement in the tear meniscus.The anterior segment optical coherence tomography is valuable to measure dynamic changes in the tear meniscus.