眼睑松弛综合征手术前后眼表变化的临床研究

Clinical study on the changes of ocular surface before and after blepharochalasia syndrome operation

目的观察研究眼睑松弛综合征患者手术前后眼表各项指标。方法30例眼睑松弛综合征患者,均行双眼重睑形成联合上睑下垂矫正及泪腺脱垂复位手术治疗,分别对患者术前、术后1周、术后1个月、术后3个月的眼表疾病指数问卷(OSDI)、泪膜破裂时间(BUT)、基础泪液分泌试验(SchirmerⅠ)、角膜荧光素染色(FLS)评分,泪河高度(TMH)、睑缘形态异常(LMS)评分等各项眼表指标进行比较。结果患者术后1周、1个月及3个月的OSDI评分分别为(16.73±4.49)、(15.33±4.61)、(14.36±4.56)分,BUT分别为(10.26±3.59)、(12.21±3.59)、(12.85±4.73)分,FLS评分分别为(1.75±0.98)、(1.28±0.89)、(1.15±0.93)分,较均术前的(25.30±4.43)分、(5.25±1.68)s、(2.55±1.03)分改善,差异有统计学意义(P<0.05);患者术后1周、1个月及3个月的OSDI评分、BUT、FLS评分比较差异无统计学意义(P>0.05);患者术前术后各时间段Schirmer I、TMH及LMS评分比较差异无统计学意义(P>0.05)。结论眼睑松弛综合征通过手术治疗改善外观的同时促进眼表的修复,提升眼部舒适度,缓解患者临床症状。

Objective To observe and research the changes of ocular surface before and after blepharochalasia syndrome operation.Methods A total of 30 cases of blepharochalasia syndrome underwent underwent double eyelid formation combined with correction of blepharoptosis and reduction of lacrimal gland prolapse.All ocular surface indicators of ocular surface disease index(OSDI),break-up time(BUT),SchirmerⅠtest,cornea fluorescein staining(FLS),tear meniscus height(TMH)and marginal morphology score(LMS)before operation,1 week,1 month,3 months after operation was compared and analyzed.Results The OSDI score at 1 week,1 month and 3 months after operation were(16.73±4.49),(15.33±4.61)and(14.36±4.56)points respectively,BUT were(10.26±3.59),(12.21±3.59)and(12.85±4.73)points respectively,FLS score were(1.75±0.98),(1.28±0.89)and(1.15±0.93)points respectively,which were all improved than(25.30±4.43)points,(5.25±1.68)s and(2.55±1.03)points before operation.Their difference was statistically significant(P<0.05).There was no statistically significant difference in OSDI score,BUT and FLS score at 1 week,1 month and 3 months after operation(P>0.05).There was no statistically significant difference in Schirmer I,TMH and LMS score before and after operation(P>0.05).Conclusion Surgery for blepharochalasia syndrome can improve the appearance,promote the repair of the eye surface,improve the comfort of the eyes,and relieve the clinical symptoms of the patients.