关于斜视手术中角膜保护对眼表影响的研究

The clinical significance of corneal protection to the ocular surface in strabismus surgery

目的了解斜视手术对眼表的影响，探讨术中角膜保护的临床意义。方法征募年龄为7-45岁斜视患者，随机分为三组，A组（生理盐水组）、B组（角膜保护剂组）、c组（棉片组），于术前1天及术后1天、1周、3周，检测术眼泪膜破裂时间及泪河高度值，并行角膜上皮荧光素染色评分。于术后1天，客观评价患者畏光流泪情况。最后，对三组资料采用统计学方法进行分析比较。结果所有患者术后的泪膜破裂时间与术前相比均无统计学差异（P〉0．05）。与其它两组相比，角膜保护剂组的术后畏光流泪症状及角膜上皮荧光素染色阳性率最低，泪河高度值增加最少，并于术后一周时恢复至术前水平。结论斜视手术中应注重角膜的保护，角膜保护剂使用方便，可有效保护术眼角膜上皮，减少患者术后不适症状。

Objective To study the influence of corneal protection on the ocular surface and its clinical significance in strabismus surgery. Methods Strabismus patients aged from 7 to 45 years old were collected and divided into 3 groups according to the difference of corneal protection. At differ- ent time points, the first noninvasive tear film break-up time, average noninvasive tear film break-up time, and tear meniscus height were measured and the cornea fluorescein staining was evaluated. On the first day after surgery, the symptom of photophobia was observed. Finally, all the data were ana- lyzed by statistics. Results The tear film break-up time wasn＇t influenced by the surgery. Against other two groups,the occurrence rate of the symptom of photophobia and the positive cornea fluores- cein staining were lower in the group B. The tear meniscus height of the group B increased little at 1 day after surgery and decreased to the preoperative level at one week after surgery. Conclu- sions Protecting the cornea in strabismus surgery by the 2% hydroxypropyl methycellulose can make patients more comfortable after operation.It＇s simple and meaningful to do this during the surgery.