翼状胬肉手术前后泪膜质量与视力变化

Changes of tear film quality and visual acuity before and after pterygium surgery

目的:探讨翼状胬肉患者手术前后泪膜质量和视力变化。方法:将50例(50眼)鼻侧单头翼状胬肉患者按翼状胬肉面积大小分为大面积组与小面积组,患者均接受翼状胬肉切除联合自体角膜缘移植术。记录并比较各组患者术前、术后1周、术后1个月的裸眼视力、矫正视力和泪膜破裂时间。结果:与术前相比,患者术后1周、术后1个月裸眼视力、矫正视力均有升高,差异有统计学意义(P<0.01)。术后平均泪膜破裂时间较术前变短,术前和术后1周、术前和术后1个月差异有统计学意义(P<0.05),术后1周及术后1个月差异无统计学意义(P>0.05)。此外,翼状胬肉面积与术前裸眼视力、矫正视力、平均泪膜破裂时间之间均不存在相关性(P>0.05)。结论:翼状胬肉手术可有效提高患者裸眼视力、矫正视力,使患者获得更清晰的视觉体验;但在术后一段时间内泪膜质量有所下降,术后应积极使用人工泪液维持泪膜稳定性。

Objective： To investigate the variation trend of the tear film quality and visual acuity before and after the pterygium surgery. Methods： Fifty eyes of fifty patients with single nasal pterygium were divided into the large groups and the small groups according to the size of pterygium. All patients were performed the pterygium excision and self-bulbar conjunctiva transplantation. The value of uncorrected visual acuity（UCVA）, corrected visual acuity（CVA） and average tear film rupture time were evaluated before and 1-week after and 1-month after surgery in each group and compared with each other. Results： Compared with preoperative values, the values of UCVA and VCA were significantly improved at 1-week and 1-month after（both P〈0.01）. The value of average tear film rupture time was significantly decreased before and 1 week after surgery, and before and 1 month after surgery（both P〈0.05）. The values did not significantly differ at 1 week and 1 month after surgery（P〈0.05）. Besides, the UCVA, VCA and average tear film rupture time before surgery were not significantly correlated with size of the pterygium（all P〉0.05）. Conclusion： Pterygium surgery can improve UCVA, CVA and visual acuity. But the quality of tear film is decreased after the surgery. Consequently, the artificial tears should be used positively to maintain the stability of the tear film.