以角膜缘与穹窿部为基底结膜瓣行小梁切除术对青光眼患者泪膜的影响

Effect of trabeculectomy with limbus and palate as basal conjunctival flap on tear film in patients with glaucoma

目的观察以角膜缘与穹窿部为基底结膜瓣行小梁切除术对青光眼患者泪膜的影响。方法将2017年6月-2018年5月我院治疗的青光眼患者102例(130眼)作为研究对象,将其应用随机数表法分为对照组(51例,64眼)、观察组(51例,66眼)。入选者均行小梁切除术治疗,对照组以穹窿部为基底结膜瓣,观察组则以角膜缘为基底结膜瓣。观察两组术后畏光感、干涩异物感评分及泪膜情况。结果术前两组畏光感评分、干燥异物感评分、角膜荧光染色检测积分(FL)评分、泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)水平对比,差异无统计学意义(P>0.05);与对照组相比,观察组畏光感评分、干燥异物感评分、FL评分较低,SⅠt、BUT水平较高,差异有统计学意义(P<0.05)。结论小梁切除术中以角膜缘为基底结膜瓣可减轻青光眼患者术后眼部不适或干眼,且对泪膜的影响较小。

Objective To observe the effect of trabeculectomy with the limbus and iliac crest on the tear film of glaucoma patients. Methods A total of 102 patients (130 eyes) with glaucoma treated in our hospital from June to May 2018 were enrolled in the study. The patients were randomly divided into the control group (51 cases, 64 eyes) and the observation group (51cases, 66 eyes). All the patients were treated with trabeculectomy. The control group was treated with the palpebral conjunctival flap, while the observation group was treated with the limbus as the basement conjunctival flap. The postoperative photophobia, dry foreign body sensation score and tear film were observed. Results There were no statistically significant differences between the two groups in terms of photophobic sensation score, dry foreign body sensation score, corneal fluorescence staining score (FL) score, tear secretion test (SIt) and tear film rupture time (BUT). 0.05);Compared with the control group, the obedience score, dry foreign body sensation score, FL score were lower in the observation group, and the SIt and BUT levels were higher, the difference was statistically significant (P<0.05). Conclusion The keratoconjunctival flap in trabeculectomy can reduce the postoperative eye discomfort or dry eye in patients with glaucoma and has less effect on the tear film.