可吸收泪小管栓子VisiPlug植入后对干眼症病人相关指标影响

IMPACT OF ABSORBABLE LACRIMAL EMBOLI VisiPlug IMPLANTATION ON RELATED INDEXES OF PATIENTS WITH DRY EYE DISEASE

目的探讨可吸收泪小管栓子VisiPlug植入后对中、重度干眼症病人相关指标的影响。方法中、重度干眼症病人18例（36眼）,给予双眼上下泪小管植入可吸收泪小管栓子VisiPlug,分别于治疗前和治疗后的第1周、1个月、3个月、6个月进行主观症状评分、基础泪液分泌实验、角膜荧光素染色评分、泪膜破裂时间观察和泪河高度检查。结果无病人出现泪小管栓子脱落,1例病人出现不能耐受的泪溢症状,将下泪小管内的栓子冲洗入泪囊后缓解。治疗后第1周、1个月、3个月、6个月病人主观症状评分、角膜荧光素染色评分、泪膜破裂时间和泪河高度与治疗前比较,差异有显著性（F=26.79~259.18,P〈0.01）;治疗后第1、3、6个月与治疗后第1周相比,主观症状评分、角膜荧光素染色评分、泪膜破裂时间比较差异有显著性（P〈0.05）;治疗前与治疗后第1周、1个月、3个月、6个月基础泪液分泌测量结果比较差异无显著性（P〉0.05）;治疗后第1周、1个月、3个月、6个月泪河高度比较差异无显著性（P〉0.05）。结论可吸收泪小管栓子VisiPlug植入是安全的,并且在未降解期间可以显著改善干眼症病人的相关指标。

Objective To investigate the impact of absorbable lacrimal emboli VisiPlug implantation on related indexes of patients with moderate to severe dry eye disease. Methods Eighteen patients （36 eyes） with moderate to severe dry eye disease were enrolled in this study. An absorbable VisiPlug was implanted in binocular upper and lower lacrimal duct. The subjective symptom score, Schirmer Ⅱ test, corneal fluorescein staining score, tear break-up time and tear meniscus height were checked-Before and in the 1st week, and in the 1st,3rd and 6th month after treatment. Results No spontaneous plug loss was noted in all the patients. One patient could not tolerate the symptom of tears overflow, which was relieved after the lacrimal embolus was flushed into the lacrimal sac. The differences in subjective symptom score, corneal fluorescein staining score, tear break-up time and tear meniscus height between before and after treatment were significant （F=26.79-259.18,P〈0.01）. A comparison between the first week after treatment and after the first, third and sixth month of treatment indicated that the differences in subjective symptom score, corneal fluorescein staining score and tear break-up time were statistically significant （P〈0.05）. The difference in baseline tear secretion test between before treatment and the first week, the first month, the third month and the sixth month after treatment was not significant （P〉0.05）. There was no significant differences in the tear meniscus height among the first week, the first month, the third month and the sixth month after treatment （P〉0.05）. Conclusion Implantation of absorbable lacrimal emboli VisiPlug is safe for dry eye disease, and during the period of non degration, it can notably improve the related indexes of patients with the disease.