目的观察角膜绷带镜对生物工程角膜移植术后的临床治疗作用。方法收集我院2017年1月至2018年6月住院并使用生物工程角膜进行板层角膜移植手术治疗的感染性角膜溃疡患者30例30眼的临床资料,随机分为A、B两组,各15例。A组角膜上皮愈合后...目的观察角膜绷带镜对生物工程角膜移植术后的临床治疗作用。方法收集我院2017年1月至2018年6月住院并使用生物工程角膜进行板层角膜移植手术治疗的感染性角膜溃疡患者30例30眼的临床资料,随机分为A、B两组,各15例。A组角膜上皮愈合后给予戴角膜绷带镜联合滴眼液点眼治疗,2周更换1次,术后3个月拆线后停用。B组患者不戴角膜绷带镜,药物治疗同A组。观察生物工程角膜移植术后角膜植片上皮化时间,比较术后第1、2、3、4周两组角膜植片水肿程度,比较术后第1、2、3个月两组角膜植片上皮完整性和泪膜破裂时间(breakup time of tear film,BUT),比较两组角膜植片水肿消退时间和术后3个月两组角膜植片存活率。结果术后3~5 d角膜植片上皮化,2~4周植片水肿消退。A组患者术后第2~3周角膜植片水肿消退,B组患者第3~4周角膜植片水肿消退,时间长于A组(P <0.001),术后第2~3周A组角膜植片水肿程度明显轻于B组(第2周P=0.002,第3周P <0.001)。术后第1、2、3个月时A组患者角膜荧光素染色评分均低于B组(均P <0.001),BUT时长高于B组(P=0.009、0.002、0.33)。A组患者中1例未按时复诊戴角膜绷带镜近5周,继发细菌感染,退出研究,术后3个月A组植片存活率93.3%(14/15);B组患者有2例1个月后出现角膜上皮无菌性缺损,另有1例术后2个月出现角膜溶解,3例均退出研究,术后3个月B组植片存活率80.0%(12/15),与A组相比差异无统计学意义(P=0.283)。结论生物工程角膜上皮化后戴角膜绷带镜可加速角膜植片水肿消退,保护角膜上皮完整性,维持眼表泪液稳定,有利于维护眼表微环境健康,对生物工程角膜术后角膜植片修复有明显促进作用。展开更多
AIM: To determine the role of subjective assessment using Mc Monnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests.METHODS: There were 500 patients screened for dry eye us...AIM: To determine the role of subjective assessment using Mc Monnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests.METHODS: There were 500 patients screened for dry eye using Mc Monnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time(TBUT) of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease(≥grade 1). Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between Mc Monnies score(MS) and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability(P) value using Chi-square test of 【0.005 was taken as significant.· RESULTS: Dry eye prevalence with symptoms(questionnaire), Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%,15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms(MS】20), 75.86% had a low TBUT(【10s), 58.62% had a low Schirmer’s I test(≤10 mm),86.20% had Rose Bengal staining score of ≥1, 79.31%had Lissamine green staining score of ≥1. We found statistically significant associations between positive Schirmer test and arthritis(P 【0.002), dryness elsewhere(P 【0.001), contact lens use(P 【 0.002), systemic medication(P 【0.0001), sleeping with eyes partly open(P 【0.002), history of dry eyes treatment(P 【0.0001),environmental factors(P 【0.001), swimming(P 【0.001).· CONCLUSION: Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT,Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye.展开更多
目的探讨心脏死亡后捐献(donation after cardiac death,DCD)角膜供体行穿透性角膜移植术后泪膜功能的变化。方法对27例2016年3月至2017年3月之中在昆明市第一人民医院行DCD来源的穿透性角膜移植术的患者,以自体健眼作为对照组。分别于...目的探讨心脏死亡后捐献(donation after cardiac death,DCD)角膜供体行穿透性角膜移植术后泪膜功能的变化。方法对27例2016年3月至2017年3月之中在昆明市第一人民医院行DCD来源的穿透性角膜移植术的患者,以自体健眼作为对照组。分别于术前、术后1周、术后1～6月进行随访,双眼均做系统检查:裂隙灯下角膜、前房深度、虹膜等前节检查并行患者主观感觉问卷、双眼泪膜破裂时间(BUT)、泪河高度检查。使用SPSS将结果作统计学t检验分析。结果 (1)当无角膜移植排斥反应时,穿透性角膜移植术后6个月内术眼泪膜破裂时间低于健眼(P<0.05),但患者无明显眼部干眼等症状;泪河高度值在6个月内比较健眼有统计学意义(P<0.05);(2)当排斥发生时,术眼泪膜破裂时间为0;术眼泪河高度明显高于健眼。结论穿透性角膜移植术后6个月内,术眼的泪膜稳定性尚未恢复到正常水平,当发生排斥反应时稳定性急剧下降,在术后随访中依据病情使用角膜营养、抗排斥、神经营养药物等提前预防干眼症、角膜排斥等并发症。展开更多
文摘目的观察角膜绷带镜对生物工程角膜移植术后的临床治疗作用。方法收集我院2017年1月至2018年6月住院并使用生物工程角膜进行板层角膜移植手术治疗的感染性角膜溃疡患者30例30眼的临床资料,随机分为A、B两组,各15例。A组角膜上皮愈合后给予戴角膜绷带镜联合滴眼液点眼治疗,2周更换1次,术后3个月拆线后停用。B组患者不戴角膜绷带镜,药物治疗同A组。观察生物工程角膜移植术后角膜植片上皮化时间,比较术后第1、2、3、4周两组角膜植片水肿程度,比较术后第1、2、3个月两组角膜植片上皮完整性和泪膜破裂时间(breakup time of tear film,BUT),比较两组角膜植片水肿消退时间和术后3个月两组角膜植片存活率。结果术后3~5 d角膜植片上皮化,2~4周植片水肿消退。A组患者术后第2~3周角膜植片水肿消退,B组患者第3~4周角膜植片水肿消退,时间长于A组(P <0.001),术后第2~3周A组角膜植片水肿程度明显轻于B组(第2周P=0.002,第3周P <0.001)。术后第1、2、3个月时A组患者角膜荧光素染色评分均低于B组(均P <0.001),BUT时长高于B组(P=0.009、0.002、0.33)。A组患者中1例未按时复诊戴角膜绷带镜近5周,继发细菌感染,退出研究,术后3个月A组植片存活率93.3%(14/15);B组患者有2例1个月后出现角膜上皮无菌性缺损,另有1例术后2个月出现角膜溶解,3例均退出研究,术后3个月B组植片存活率80.0%(12/15),与A组相比差异无统计学意义(P=0.283)。结论生物工程角膜上皮化后戴角膜绷带镜可加速角膜植片水肿消退,保护角膜上皮完整性,维持眼表泪液稳定,有利于维护眼表微环境健康,对生物工程角膜术后角膜植片修复有明显促进作用。
基金Supported partly by Indian Council of Medical Research(ICMR)
文摘AIM: To determine the role of subjective assessment using Mc Monnies dry eye questionnaire in diagnosing dry eye disease and its association with clinical tests.METHODS: There were 500 patients screened for dry eye using Mc Monnies dry eye questionnaire between May to October 2013 at the outpatient Department of Ophthalmology of a medical college hospital. All 500 patients were subjected to clinical tests. Dry eye was defined as having one or more symptoms often or all the time. Positive signs were if one or both eyes revealed tear film breakup time(TBUT) of ≤10s, a Schirmer test score of ≤10 mm, a Rose Bengal staining score of ≥1, a Lissamine green staining score of ≥1 or existence of meibomian gland disease(≥grade 1). Statistical analysis was performed to describe the distribution of symptoms and signs, to assess the correlations between Mc Monnies score(MS) and variable clinical signs of dry eye, and to explore the association between dry eye symptoms and variable clinical signs. Analysis was performed using software package Epi info. A Probability(P) value using Chi-square test of 【0.005 was taken as significant.· RESULTS: Dry eye prevalence with symptoms(questionnaire), Schirmer test, TBUT, Rose Bengal staining and Lissamine green staining was 25.6%,15.20%, 20.80%, 23.60%, and 22.60% respectively. Among those with severe symptoms(MS】20), 75.86% had a low TBUT(【10s), 58.62% had a low Schirmer’s I test(≤10 mm),86.20% had Rose Bengal staining score of ≥1, 79.31%had Lissamine green staining score of ≥1. We found statistically significant associations between positive Schirmer test and arthritis(P 【0.002), dryness elsewhere(P 【0.001), contact lens use(P 【 0.002), systemic medication(P 【0.0001), sleeping with eyes partly open(P 【0.002), history of dry eyes treatment(P 【0.0001),environmental factors(P 【0.001), swimming(P 【0.001).· CONCLUSION: Subjective assessment plays an important role in diagnosing dry eye disease. There is strong correlation between MS and Schirmer test, TBUT,Rose Bengal staining and Lissamine green staining in normal as well as marginal and pathological dry eye.
文摘目的探讨心脏死亡后捐献(donation after cardiac death,DCD)角膜供体行穿透性角膜移植术后泪膜功能的变化。方法对27例2016年3月至2017年3月之中在昆明市第一人民医院行DCD来源的穿透性角膜移植术的患者,以自体健眼作为对照组。分别于术前、术后1周、术后1～6月进行随访,双眼均做系统检查:裂隙灯下角膜、前房深度、虹膜等前节检查并行患者主观感觉问卷、双眼泪膜破裂时间(BUT)、泪河高度检查。使用SPSS将结果作统计学t检验分析。结果 (1)当无角膜移植排斥反应时,穿透性角膜移植术后6个月内术眼泪膜破裂时间低于健眼(P<0.05),但患者无明显眼部干眼等症状;泪河高度值在6个月内比较健眼有统计学意义(P<0.05);(2)当排斥发生时,术眼泪膜破裂时间为0;术眼泪河高度明显高于健眼。结论穿透性角膜移植术后6个月内,术眼的泪膜稳定性尚未恢复到正常水平,当发生排斥反应时稳定性急剧下降,在术后随访中依据病情使用角膜营养、抗排斥、神经营养药物等提前预防干眼症、角膜排斥等并发症。
