老年性下睑内翻矫正联合眼袋去除术后眼表改变

Changes of ocular surface after correction of senile lower lid entropion combined with pouch repair

目的观察老年性下睑内翻矫正联合眼袋去除术后眼表改变。方法选取2015年10月至2019年4月于我院就诊的28例(28只眼)患有单眼老年性下睑内翻合并眶脂肪脱垂的患者,年龄在56~75岁,将28例(56只眼)患者双眼分为手术组眼与非手术组眼,其中手术组眼为患有老年性下睑内翻合并眶脂肪脱垂眼,行下睑内翻矫正联合眼袋去除术;非手术组眼为同一患者另一只健眼,无需处理。分别在术前及术后7 d、1个月、3个月填写眼表疾病指数(OSDI)量表,进行泪膜破裂时间测定(BUT)、泪液分泌试验(SIt)和角膜荧光素染色(FL)检查,观察眼表变化。结果手术眼组患者术前与术后7 d、1个月OSDI量表比较无统计学差异(P>0.05),术后3个月与术前OSDI量表比较差异明显,具有统计学差异(P<0.05)。手术眼组与非手术眼组在术前、术后7 d及1个月BUT、FL及SIt比较有统计学差异(P<0.05),手术组眼仍存在眼表症状,但在术后3个月时再次比较上述指标发现均无明显差异,无统计学差异(P>0.05)。结论行老年性下睑内翻矫正联合眼袋去除术后早期仍存在干眼、流泪等眼表症状,但该症状是短暂的,通常术后3个月会恢复。

Objective To detect changes of ocular surface after correction of senile lower lid entropion combined with pouch repair.Methods A total of 28 patients(28 eyes)with monocular senile lower lid entropion and orbital fat prolapse who were treated in our hospital from October 2015 to April 2019 were selected.Aged from 56 to 75 years old,28 patients(56 eyes)were divided into surgical group and non-operative group.The surgical group were treated with senile lower lid entropion correction combined with inferior pouch repair.Another group were the healthy eye of the same patient,no treatment is needed.Patients were followed up for 3 months.Ocular surface disease index(OSDI),break-up time(BUT),Schirmer's test(SIt)and cornea fluorescein stain(FL)were assessed,and observe the ocular surface changes.Results Compared to pre-operative levels,there were statistically significant differences in the OSDI scale 3 months after surgery(P<0.05).Compared to the non-operative group,BUT,FL,SIt score in operative group were significantly higher in 1 week and 1 month(P<0.05).Conclusions Correction of senile lower lid entropion combined with pouch repair can affect the ocular surface and may lead to dry eyes and tears.However,this effect is temporary and usually recovers 3 months after surgery.