泪膜破裂时间与角膜移植术后上皮修复的相关性分析

Correlation analysis of tear break-up time on epithelial rehabilitation after keratoplasty

目的了解泪膜破裂时间与角膜移植术后上皮修复时间的相关性。方法检查2015年6月-2016年5月昆明市第一人民医院预进行角膜移植病人的泪膜破裂时间,排除干扰或测定不到泪膜破裂时间的病人;将符合条件的病人,按平均泪膜破裂时间将病人分组为正常(≥10s)、低分泌(<10s且≥5s)、干眼(<5s)3组,分别记录3组病人角膜上皮修复时间;经P值计算得出3组病人角膜上皮修复时间有无统计学差异。结果入选病例37例,均为单眼,正常组21例,角膜上皮修复平均时间(2±1.989)d,低分泌组11例,角膜上皮修复平均时间(3±1.674)d,干眼组5例,角膜上皮平均修复时间(5±1.657)d,其中2例出现修复后再次上皮脱落,给予促进上皮修复及绷带镜配置后病情稳定。低分泌组较正常组角膜上皮修复时间明显延长,P<0.05;干眼组较正常组角膜上皮修复时间明显延长,P<0.05;干眼组较低分泌组角膜上皮修复时间明显延长,P<0.05。结论术前泪膜破裂时间与角膜移植术后角膜上皮修复时间长短关系密切。泪膜破裂时间正常的患者术后上皮修复明显较快,泪液低分泌及干眼患者术后上皮修复时间较泪膜破裂时间正常的患者明显延长,而泪液低分泌的患者较干眼患者术后上皮修复时间短。

Objective To analyze the relationship between tear break-up time（BUT） and the rehabilitation time of epithelium after keratoplasty. Methods BUT of the patients that were preparing to do the keratoplasty from June, 2015 to May, 2016 were examined without patients whose BUT examination were not able to get or disturbed obviously. The patients who were eligible were divided into 3 groups depend on the average BUT by normal（≥10 s）, low secretion（〈10 s and ≥5 s） and dry eye（〈5 s）. The time of epithelium rehabilitation after keratoplasty were recorded respectively. To determine the association between the duration of rehabilitation of epithelium based on the result of p value. Results All patients that were involved in is 37. All were monocular. Normal group has 21 patients, and the average duration of epithelium rehabilitation is（2±1.989） days. Low secretion group has 11 patients, and the average duration of epithelium rehabilitation is（3±1.674） days. Dry eye group has 5 patients, and the average duration of epithelium rehabilitation is（5±1.657） days. 2 of the dry eye group dropped the epithelium after the rehabilitation at first, but got to a stable condition after treatment to promote the rehabilitation and the use of contact lens. The duration of rehabilitation of epithelium in different groups are various obviously, P〈0.05. Conclusion The relationship between BUT before keratoplasty and the duration of rehabilitation of epithelium has significant difference. The duration of rehabilitation of epithelium in low secretion group is longer than normal group obviously. The duration of rehabilitation of epithelium in dry eye group is longer than normal group obviously. The duration of rehabilitation of epithelium in dry eye group is longer than low secretion group obviously.