改良Parks切口与角膜缘切口治疗斜视的效果及对眼表环境的影响

Effect of modified Parks incision and limbal incision in the treatment of strabismus and its effect on ocular surface environment

目的探讨改良Parks切口与角膜缘切口治疗斜视的效果及对眼表环境的影响。方法选择2019年1月至2022年1月宝鸡市人民医院眼科收治的200例斜视患者展开研究,按照随机数表法分为观察组和对照组各100例,两组患者均接受斜视手术治疗,观察组患者使用改良Parks切口,对照组患者使用角膜缘切口。比较两组患者术后2周的临床疗效,术前、术后2周泪液分泌试验(SIT)、泪膜破裂时间(BUT)、干眼症状评分、角膜荧光素染色(FL)评分的变化及并发症发生率。结果术后2周,观察组患者的临床治疗总有效率为95.00%,明显高于对照组的86.00%,差异有统计学意义(P<0.05);术后2周,观察组患者的SIT、BUT分别为(10.87±1.65)mm/5 min、(10.50±1.63)s,明显高于对照组的(9.49±1.34)mm/5 min、(9.26±1.75)s,差异均有统计学意义(P<0.05);术后2周,观察组患者的干眼症状评分、FL评分分别为(1.87±0.20)分、(1.14±0.12)分,明显低于对照组的(2.42±0.34)分、(1.38±0.14)分,差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为2.00%,明显低于对照组的9.00%,差异有统计学意义(P<0.05)。结论与角膜缘切口相比,改良Parks切口治疗斜视患者的效果更好,其不仅可提高临床疗效,且对眼表环境影响小。

Objective To investigate the effect of modified Parks incision and limbal incision in the treatment of strabismus and its effect on ocular surface environment.Methods A total of 200 patients with strabismus admitted to Department of Ophthalmology,Baoji People's Hospital from January 2019 to January 2022 were selected for the study.According to the random number table method,they were divided into an observation group and a control group,with 100 patients in each group.All patients received strabismus surgery.The patients in the observation group were treated with modified Parks incision,and the patients in the control group were treated with limbal incision.The clinical efficacy at 2 weeks after surgery,tear secretion test(SIT),break-up time(BUT)of tear film,dry eye symptom score,corneal fluorescein staining(FL)score at preoperative and postoperative 2 weeks,and incidence of complications were compared between the two groups.Results Two weeks after surgery,the total effective rate of clinical treatment in the observation group was 95.00%,which was significantly lower than 86.00%in the control group(P<0.05).Two weeks after surgery,the SIT and BUT in the observation group were(10.87±1.65)mm/5 min and(10.50±1.63)s,which were significantly higher than(9.49±1.34)mm/5 min and(9.26±1.75)s in the control group(P<0.05).Two weeks after surgery,the dry eye symptom score and FL score in the observation group were(1.87±0.20)points and(1.14±0.12)points,which were significantly lower than(2.42±0.34)points and(1.38±0.14)points in the control group(P<0.05).The total incidence of complications in the observation group was 2.00%,which was significantly lower than 9.00%in the control group(P<0.05).Conclusion Compared with limbal incision,the modified Parks incision is more effective in the treatment of strabismus,which can not only improve the clinical efficacy,but also has little impact on the ocular surface environment.