Clinical associations of corneal neuromas with ocular surface diseases

Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.

Effects of estrogen replacement therapy on apoptosis and vascular endothelial growth factor expression in ocular surface epithelial cells:An experimental study

AIM:To investigate the effects of estrogen replacement therapy (ERT) on apoptosis and vascular endothelial growth factor (VEGF) expression in ocular surface in an experimental rat model.· METHODS:Forty female,Wistar rats were randomized in 4 groups in the study.Subcutaneous ERT (17β-estradiol,10g/kg/day) was administered to the first group without ovariectomy and to the second group with ovariectomy for three months.Third group had only ovariectomy and fourth group had sham operation.All rats were sacrificed in estrous cycles determined by vaginal smear test and their right eyes were enucleated at the end of the third month.Enucleated eyes were analyzed by immunohistochemical method for expressions of caspase-3,bcl-2,VEGF and TUNEL assay.· RESULTS:Caspase-3 expression of conjunctival epithelium was significantly higher in group 3 than group 1 (P =0.005),and group 2 (P =0.007).TUNEL score of conjunctival epithelium was significantly higher in group 3 than group 1 (P =0.006).TUNEL score of corneal epithelium was significantly higher in group 3 than group 2 (P =0.012),and group 4 (P =0.002).There was no significant difference between groups in that bcl-2 and VEGF expressions.· CONCLUSION:We determined increased apoptosis in ocular surface epithelial cells in ovariectomized rats.ERT and endogen estrogen decreased the apoptosis,and did not result in difference in VEGF expression between the groups.Estrogen may be beneficial for the treatment of apoptosis-mediated ocular surface disorders such as dry eye.Further studies are needed on this subject for a better understanding of the role of estrogen and to provide a new insight for treatment and prevention of apoptosis-mediated ocular surface disorders.

Ocular surface heat effects on ocular hemodynamics detected by real-time measuring device

AIM: To investigate the ocular hemodynamic effects of applying a hot compress to the eye.METHODS: The right eyes of five New Zealand white rabbits, both male and female, were hot-compressed for 18 min. An independently designed novel ocular contacttype temperature measuring device was used to measure the ocular surface temperature before and after the heating. Relevant retrobulbar hemodynamic parameters such as peak systolic velocity(PSV), end diastolic velocity(EDV), and resistance index(RI) of each of the central retinal artery(CRA), long posterior ciliary artery(LPCA), and ophthalmic artery(OA), as well as the mean velocity(V) of the central retinal vein(CRV), were measured using a color Doppler flow imaging(CDFI) technique and expressed as mean values with standard deviation(mean±SD). A statistical analysis was conducted based on a paired t-test and the Wilcoxon signed-rank test. RESULTS: The employed real-time temperature measuring device was able to accurately measure ocular surface temperature during the hot-compress process. The temperature increased after the hot compress was applied. Analysis showed that the PSV and EDV values of the CRA and LPCA significantly increased after the application of the hot compress, as did the Vof the CRV. There were no significant changes in the EDV of the OA nor the RI of each artery. CONCLUSION: This experiment, which is the first of its kind, confirms that the retrobulbar blood flow velocities can increase upon heating the ocular surface. This simple method may be useful in the future.

Human amniotic membrane transplantation: Different modalities of its use in ophthalmology

The amniotic membrane(AM) is the inner layer of the fetal membranes and consist of 3 different layers: the epithelium, basement membrane and stroma which further consists of three contiguous but distinct layers: the inner compact layer, middle fibroblast layer and the outermost spongy layer. The AM has been shown to have anti-inflammatory, anti-fibrotic, anti-angiogenic as well as anti-microbial properties. Also because of its transparent structure, lack of immunogenicity and the ability to provide an excellent substrate for growth, migration and adhesion of epithelial corneal and conjunctival cells, it is being used increasingly for ocular surface reconstruction in a variety of ocular pathologies including corneal disorders associated with limbal stem cell deficiency, surgeries for conjunctival reconstruction, as a carrier for ex vivo expansion of limbal epithelial cells, glaucoma surgeries and sceral melts and perforations. However indiscriminate use of human AM needs to be discouraged as complications though infrequent can occur. These include risk of transmission of bacterial, viral or fungal infections to the recipient if the donors are not adequately screened for communicable diseases, if the membrane is not processed under sterile condi-tions or if storage is improper. Optimal outcomes can be achieved only with meticulous case selection. This review explores the ever expanding ophthalmological indications for the use of human AM.

History and Clinical Validation of the PASCAL^®Dynamic Contour Tonometer

Will Goldmann Applanation Tonometry, the age old “gold standard” of intraocular pressure (IOP) measurement, be replaced with newer methods? One of the newer methods of IOP measurement is Pascal, dynamic contour tonometry (DCT). A review of the history, scientific principles, clinical validation and clinical utility of DCT is presented.

Aplication of <i>in Vivo</i>Confocal Microscopy in Ophtalmology—Overview

Confocal microscopy is a method which has been increasingly used over the last decade in the study of the anterior ocular surface. The method allows testing and in vivo high resolution imaging of the structures of the anterior eye segment, at a cellular level, which is close to the histological examination of tissues. The data provided by this method allow for a better understanding of both the functional and pathological processes occurring in the anterior ocular surface not only for scientific purposes but also in clinical practice. The aim of the present work is to summarize the current knowledge and applications of confocal microscopy of the anterior ocular surface.

Amniotic membrane transplantation: an updated clinical review for the ophthalmologist

Although amniotic membrane transplantation(AMT)has long been used as an essential surgical technique for ocular surface reconstruction,its role continues to evolve and expand.In the management of numerous ocular surface disorders,ranging from inflammatory to infectious,traumatic to neoplastic,the ability to perform AMT is a valuable addition to the skillset of any ophthalmologist.The purpose of this paper is to provide ophthalmologists with an updated,evidence-based review of the clinical indications for AMT in corneal and conjunctival reconstruction,reviewing its common and even experimental applications known to date.The methods of amniotic membrane preservation,the available commercial amniotic membrane products to date,and future directions for amniotic membrane use,including amniotic membrane extract eye drops(AMEED),are also discussed.It is paramount for ophthalmologists to stay up-to-date on the applications of AMT so as to effectively incorporate this versatile treatment modality into their practice,both in the operating room and in the clinic.By familiarizing the general ophthalmologist with its diverse applications,we hope to motivate general ophthalmologists to incorporate the use of AMT into their clinical practice,or provide guidance on how to recognize when referral to a corneal specialist for amniotic membrane application is prudent.

抗菌肽在眼表感染性疾病中的应用进展

眼表长时间暴露在外部环境下,很容易患各种眼表感染性疾病。近年来,由于病原体对抗菌药物的耐药性问题,眼表感染性疾病患者呈现治疗效果不佳、视力和生活质量严重下降等情况。目前,眼表感染性疾病已成为一个全球性的公共卫生问题,寻找一种安全、有效的治疗药物迫在眉睫。抗菌肽作为抗生素类似物,具有广谱抗菌性,能有效抵抗各种微生物的感染,包括细菌、病毒、真菌和寄生虫。抗菌肽在眼表感染性疾病的治疗中发挥着重要作用。本文就抗菌肽的结构与功能、抗菌肽在眼表感染性疾病中的作用机制、内源性抗菌肽在眼表感染中针对不同病原体的作用、外源性诱导抗菌肽对眼表感染性疾病的作用以及抗菌肽研究的最新进展等进行综述。

角膜缘微环境细胞的分离培养研究进展

角膜缘微环境细胞(LNCs)是位于角膜缘、与角膜缘上皮干细胞(LESCs)紧密相连的一类间充质干细胞,能同时表达间充质标志物和多种胚胎干细胞标志物,对调节LESCs的静息、自我更新以及分化状态起着重要作用。近年研究表明,LNCs可通过胶原酶消化法、上皮块消化法、中性蛋白酶-胶原酶消化法以及组织块培养法进行体外分离培养,通过3D Matrigel共培养、Transwell共培养可研究LNCs与LESCs之间的相互作用关系。LNCs与LESCs可通过SDF-1/CXCR4、Notch、BMP、Wnt、Sonic Hedgehog、KIT/AKT等多种信号通路以及神经生长因子、角质形成细胞因子、胰岛素样生长因子等多种细胞因子相互作用。LNCs现已成为角膜上皮组织工程、眼表重建以及角膜再生等研究中的一大热点。本文就LNCs的研究背景、体外分离培养方法、与LESCs的相互作用机制及其应用前景等进行综述。

角膜淋巴管生成的内源性调控因素及新生淋巴管相关眼表疾病研究进展

正常角膜无血管和淋巴管。角膜感染、化学烧伤、移植排斥反应等病理性刺激可破坏促淋巴管生成因素与抗淋巴管生成因素间的平衡,致使淋巴管从角膜缘向角膜中央延伸。角膜新生淋巴管的形成与多种调控因素及细胞信号通路密切相关,深入研究并阐明角膜淋巴管生成的机制将为角膜移植排斥反应、炎症性疾病、干眼症和肿瘤转移等相关领域的研究开辟新的方向。本文综述了角膜淋巴管生成的内源性调控因素及新生淋巴管相关眼表疾病的治疗策略。

Diabetic corneal neuropathy as a surrogate marker for diabetic peripheral neuropathy

Diabetic neuropathy is a prevalent microvascular complication of diabetes mellitus,affecting nerves in all parts of the body including corneal nerves and peripheral nervous system,leading to diabetic corneal neuropathy and diabetic peripheral neuropathy,respectively.Diabetic peripheral neuropathy is diagnosed in clinical practice using electrophysiological nerve conduction studies,clinical scoring,and skin biopsies.However,these diagnostic methods have limited sensitivity in detecting small-fiber disease,hence they do not accurately reflect the status of diabetic neuropathy.More recently,analysis of alterations in the corneal nerves has emerged as a promising surrogate marker for diabetic peripheral neuropathy.In this review,we will discuss the relationship between diabetic corneal neuropathy and diabetic peripheral neuropathy,elaborating on the foundational aspects of each:pathogenesis,clinical presentation,evaluation,and management.We will further discuss the relevance of diabetic corneal neuropathy in detecting the presence of diabetic peripheral neuropathy,particularly early diabetic peripheral neuropathy;the correlation between the severity of diabetic corneal neuropathy and that of diabetic peripheral neuropathy;and the role of diabetic corneal neuropathy in the stratification of complications of diabetic peripheral neuropathy.

Consilience and unity in ocular anterior segment research

In his beautiful book,Consilience:The Unity of Knowledge,the eminent biologist Edward O Wilson,advocates the need for integration and reconciliation across the sciences.He defines consilience as“literally a‘jumping together’of knowledge with a linking of facts…to create a common groundwork of explanation”.It is the premise of this paper that as much as basic biomedical research is in need of data generation using the latest available techniques–unifying available knowledge is just as critical.This involves the necessity to resolve contradictory findings,reduce silos,and acknowledge complexity.We take the cornea and the lens as case studies of our premise.Specifically,in this perspective,we discuss the conflicting and fragmented information on protein aggregation,oxidative damage,and fibrosis.These are fields of study that are integrally tied to anterior segment research.Our goal is to highlight the vital need for Wilson’s consilience and unity of knowledge which in turn should lead to enhanced rigor and reproducibility,and most importantly,to greater understanding and not simply knowing.

Contrast Sensitivity and Eye Drops

Purpose: To evaluate the influence of commonly used eye drops on contrast sensitivity (CS). Design: Prospective study. Participants: One hundred twenty volunteers (120) were enrolled. Methods: The CS of ophthalmologically healthy individuals was evaluated at baseline examination before the instillation, 20 and 40 minutes after the instillation of diclofenac sodium and commonly used antiglaucoma eye drops (latanoprost, brimonidine tartrate, combination of dorzolamide hydrochloride and timolol maleate). CS was assessed at 7 spatial frequencies varying from 1.5 c/d to 20 c/d by the use of Mentor B-VAT II-SG video acuity tester. Results: Diclofenac sodium induced a mild, however statistically significant decrease on the CS in 4 out of 30 subjects 20 minutes after instillation at the spatial frequency of 1.5 c/d and 3 c/d (p p > 0.05). Brimonidine tartrate decreased CS in 4 out of 30 subjects 20 minutes after the instillation at a high spatial frequency (20 c/d) yet this decrease was marginally statistically significant (p = 0.057). CS returned to baseline scores 40 minutes after the instillation for all drugs. Conclusions: Diclofenac sodium eye drops had a mild temporal effect on the low spatial frequencies of 1.5 c/d and 3 c/d in some individuals. Latanoprost and dorzolamide/timolol had a non-statistically significant effect on the same spatial frequencies. Brimonidine eye drops had a temporal effect on the high spatial frequency of 20 c/d with marginal statistical significance. The CS scores returned to normal, in all cases, within the next 40 minutes after the instillation. Ophthalmologists should be aware of the fact that some eye drops may have an influence on CS.

Conjunctival flap cover surgery:10-year review

Background:To evaluate the conjunctival flap cover surgery for the treatment of ocular surface disorders.Methods:Retrospective uncontrolled study was performed.A total of 253 eyes of 253 patients who had received conjunctival flap cover surgery during a 10-year period were included.The indications,symptoms and complications experienced by patients undergoing partial or total conjunctival flap cover surgery were reviewed.Results:In all of these cases,satisfactory anatomic and functional outcomes were achieved.The BCVA of 224 eyes out of 253 patients(88.5%)were no worse than that of preoperative and the BCVA of 29 eyes out of 253 patients(11.5%)decreased postoperatively.No eye pain,foreign body sensation and other discomforts presented in the last visit.The surgical indications was therapeutic for 138 out of 253 patients(54.5%),aesthetic for 63 eyes out of 253 patients(24.9%),tectonic for 45 eyes out of 253 patients(17.8%),and analgesic for 7 eyes out of 253 patients(2.8%).The primary diagnose of therapeutic indications is refractory corneal ulcer for 135 eyes out of 253 patients(53.4%).The main diagnose of aesthetic indications is atrophy of eyeball for 45 eyes out of 253 patients(17.8%)and corneal leukoma for 18 eyes out of 253 patients(7.1%).The principal diagnose of tectonic indications is corneal perforation for 43 eyes out of 253 patients(17%).The main intraoperative complications is buttonhole formation for 8 eyes out of 253 patients(3.2%),which can be handled by simple suture.The most severe complications postoperatively was conjunctival flaps dissolving and corneal perforation for 3 eyes out of 253 patients(1.2%),and corneal transplantation had to be performed to avoid enucleation.In addition,4 eyes out of 253 patients(1.6%)presented cystic flap and two of them received surgical excision.Conclusions:Conjunctival flap cover surgery is an underused technique.Its primary indication is refractory corneal ulcer and corneal perforation,and its second indication is aesthetic with poor visual potential coexisting ocular surface diseases.It represents an interesting alternative to more mutilating surgeries.

飞秒激光辅助白内障超声乳化摘除术对白内障不同硬度晶状体核患者眼表功能及角膜结构的影响

目的探究飞秒激光辅助白内障超声乳化摘除术对白内障不同硬度晶状体核患者眼表功能及角膜结构的影响。方法选取2018年4月至2020年8月在西安爱尔古城眼科医院接受飞秒激光联合白内障超声乳化摘除术治疗的56例(56眼)白内障患者作为研究对象,依据Emery分级法将其分为软核组(32例,Emery分级Ⅱ~Ⅲ级)和硬核组(24例,Emery分级Ⅳ~Ⅴ级)。两组均给予飞秒激光辅助白内障超声乳化摘除术治疗。比较两组的超声乳化能量、超声乳化时间、平衡盐溶液灌注量、泪膜破裂时间(BUT)、眼表疾病指数(OSDI)评分、角膜内皮细胞数目及变异系数、裸眼视力(UCVA)及最佳矫正视力(BCVA)。结果软核组的超声乳化能量及平衡盐溶液灌注量低于硬核组,超声乳化时间短于硬核组(P<0.05)。术后30 d,两组的BUT均缩短,OSDI评分均降低(P<0.05);软核组的BUT差值小于硬核组,OSDI评分差值大于硬核组(P<0.05)。术后30 d,两组的角膜内皮细胞数目均减少,角膜内皮细胞变异系数均增大(P<0.05);软核组的角膜内皮细胞数目及角膜内皮细胞变异系数差值小于硬核组(P<0.05)。术前及术后3、6个月,两组的UCVA、BCVA比较,差异无统计学意义(P>0.05);术后3、6个月,两组的UCVA、BCVA均降低(P<0.05)。结论对于软核晶状体,飞秒激光辅助白内障超声乳化摘除术治疗所需超声乳化能量少,时间短,对泪膜稳定性影响小,角膜损伤轻;对于硬核晶状体,飞秒激光辅助白内障超声乳化摘除术虽可较好恢复患者视力,但对泪膜稳定性影响大,角膜损伤重。临床中应根据晶状体核的硬度调节适宜的超声及手术参数,确保手术效果,尽可能减少术中损伤。

角膜绷带镜不能按计划连续佩戴的原因及临床特点分析

目的 分析角膜绷带镜在临床使用中出现不能按计划连续佩戴的原因及临床特点。方法 回顾性分析2020年6月至2021年6月就诊于空军军医大学西京医院眼科角膜及眼表专科患者200例(223眼),因不同原因佩戴角膜绷带镜以辅助治疗的病历资料。分析角膜绷带镜佩戴后发生的不能按计划连续佩戴的原因、发生率及其与疾病的关系。结果 佩戴角膜绷带镜以辅助治疗的患者主要是翼状胬肉术后及多种非感染性眼表损伤患者,双眼23例,单眼177例,平均年龄(53.87±12.51)岁;不能按计划连续佩戴角膜绷带镜者共22眼(9.87%),包括翼状胬肉术后6眼和非感染性眼表损伤16眼。不能按计划佩戴角膜绷带镜的原因为神经营养性角膜病变和早期眼化学伤引起的镜片自行脱落(14眼,6.28%);广泛角膜上皮糜烂的药源性眼表损伤导致的戴镜后眼部不适感加重而要求摘镜(5眼,2.24%);戴镜后出现继发性角膜感染(3眼,1.35%)。结论 角膜绷带镜在治疗眼表角膜疾病中存在一定的不能按计划连续佩戴的现象,在使用后需要随访观察。

手持式红外测温仪评估干眼患者眼表温度的研究

目的 比较正常人群与干眼患者的眼表温度(OST),评估OST用于干眼筛查的可行性。方法本研究纳入2021年12月~2022年1月在复旦大学附属眼耳鼻喉科医院干眼门诊就诊的84例(84眼)18~85岁干眼患者和20例(20眼)年龄性别匹配的正常志愿者,采用手持式红外测温仪检测受检者的体温与OST,比较不同组受检者OST的差异并且分析其与荧光染色泪膜破裂时间(FBUT)、泪液分泌试验(SⅠt)、睑板腺缺失评分及角膜荧光染色(FL)评分的关系。结果 干眼组OST值为(36.48±0.18)℃,显著低于正常组的(36.67±0.26)℃,P<0.001。干眼程度越重,OST值越低(P=0.003)。相关性分析发现,干眼患者OST值与体温、FBUT成正相关(体温:r=0.57,P<0.001;FBUT:r=0.36, P=0.001),与睑板腺缺失评分成负相关(r=-0.24,P=0.028)。将OST值36.53℃用于中重度干眼筛查,其特异度和灵敏度为78%和75%。结论 干眼患者的OST值较低,与泪膜稳定性差关系密切。使用手持式红外测温仪检测OST,具有廉价、方便和快捷的优势,有助于大范围人群的干眼筛查。

微切口超声乳化术对糖尿病合并白内障患者眼表的影响

目的:探讨白内障超声乳化手术中2.2及3.0mm透明角膜切口对2型糖尿病患者术后泪膜功能及眼表的影响。方法:收集2015-01/10在我院接受超声乳化术的2型糖尿病患者150例150眼。按照随机数字表,将其分为两组,A组微切口组(75例75眼)行2.2mm透明角膜微切口白内障超声乳化术,B组小切口组(75例75眼)行常规3.0mm透明角膜切口白内障超声乳化术,两组资料的人口统计学特征差异无统计学意义。观察并比较两组患者术前及术后1wk,1、3、6mo的眼表疾病指数(ocular surface disease index,OSDI)、角膜知觉、泪膜破裂时间(break-up time,BUT)和基础泪液分泌试验(Schirmer'sⅠtest,SⅠt)指标的变化。结果:术后1wk,1、3mo,两组患者的OSDI评分均高于术前,且B组的OSDI评分明显高于A组,差异有统计学意义(均P<0.05);两组患者的角膜知觉均较术前降低,且B组的角膜知觉明显低于A组,差异具有统计学意义(均P<0.05);两组患者的SⅠt均低于术前,且B组的SⅠt明显低于A组,差异具有统计学意义(均P<0.05)。术后1wk,1mo,两组患者的BUT均低于术前,且B组的BUT明显低于A组,差异具有统计学意义(均P<0.05)。术后6mo,A组患者的OSDI、角膜知觉、BUT和SⅠt与术前相比差异不明显,无统计学意义(均P>0.05);B组患者的OSDI评分和角膜知觉与术前相比差异明显,具有统计学意义(均P<0.05);BUT和SⅠt与术前相比差异不明显,无统计学意义(均P>0.05)。结论:2.2mm透明角膜微切口对眼表及泪膜的影响较小,对并发白内障的2型糖尿病患者尤为适用。

富血小板血浆(PRP)裂解液在苯扎溴胺诱导的小鼠干眼治疗中的作用

目的探讨富血小板血浆(platelet-rich plasma,PRP)裂解液对苯扎溴胺诱导的小鼠干眼的影响与其干眼治疗效果。方法取健康成年BALB/c小鼠36只,在无菌恒温条件下喂养。用苯扎溴胺滴眼液给小鼠滴眼制作干眼模型,并将36只小鼠随机分为模型组、A组、B组。A组小鼠用PRP滴眼、B组小鼠用生理盐水滴眼、模型组小鼠不作任何处理。对3组小鼠进行基础泪液分泌试验(SchirmerⅠtest,SⅠT)、角膜荧光素染色(fluorescein staining,FL)评分以及泪液蛋白测试,并使用共聚焦显微镜观察3组小鼠角膜上皮基底膜细胞炎症反应情况和基底膜下神经的分布(干预前和干预后1周、2周)。结果A组SIT及FL较干预前有明显改善,且干预1周后和干预后2周,比B组和模型组均有较大改善,差异均有统计学意义(均P<0.05)。干预2周后,A组角膜上皮下神经纤维密度较干预前升高(P<0.05),其他指标无明显变化,且与B组和模型组相比,角膜上皮下神经纤维分支数量明显增加,曲率评分显著下降,差异均有统计学意义(均为P<0.05)。干预2周后,A组上皮基底细胞和炎症细胞密度与其他两组相比有显著改善,差异均有统计学意义(均为P<0.05)。结论PRP滴眼液可以减少苯扎溴铵滴眼液的眼表副作用,并能通过维持小鼠泪膜的稳定性和保护角膜的完整性而控制炎症,改善干眼。

2型糖尿病角膜知觉减退及其与眼表异常的相关性研究

目的探讨2型糖尿病患者角膜知觉减退及其与眼表异常的相关性。方法采用前瞻性病例对照研究。采用Cochet-Bonnet角膜知觉测量仪分别测定并比较38例(68眼)2型糖尿病患者(糖尿病组)和33例(57眼)无糖尿病患者(对照组)中央角膜知觉,同时对糖尿病患者行泪膜破裂时间测定(break up time,BUT)、基础泪液分泌试验(SchirmerⅠ)及角膜荧光素染色。对角膜知觉与后三者进行相关性研究。结果糖尿病组角膜知觉为(36.07±14.26)mm,对照组为(52.98±3.89)mm,两者差异有显著性(P<0.01)。糖尿病患者SchirmerⅠ试验平均值为(12.41±3.22)mm,BUT值平均为(8.82±2.70)s,角膜荧光素染色累积分平均值为(3.94±1.66)分。糖尿病患者角膜知觉与泪膜破裂时间(r=0.330,P=0.006)、角膜荧光素染色(r=-0.342,P=0.004)有相关关系,与泪液分泌量无相关关系(P=0.538)。结论糖尿病患者角膜知觉明显减退,而角膜知觉减退是影响角膜上皮病变、干眼症等眼表疾病的因素之一。