论文部分内容阅读
目的探讨额肌瓣悬吊术后眼表的改变和影响其恢复的临床危险因素。方法对2007年1月至2007年4月在中山眼科中心住院的22例(32只眼)先天性上睑下垂行额肌瓣悬吊术的患者,随机平分为术后加用局部用药组(A组,11例16只眼)和术后不加用局部用药组(B组,11例16只眼),观测两个组手术后2、5、7d和2周患者泪液的分泌、泪膜破裂时间、结膜充血、角膜荧光染色、睑板腺功能、瞬目次数、睑睫毛角度和眼睑闭合情况,并分析各个观察结果是否有统计学差异。结果2例(占总例数9.1%)患者3只眼(占总眼数9.4%)因角膜上皮水肿缺损需加用促角膜上皮生长药物退出本研究,其中1例(4.5%)(2只眼)因倒睫较严重并引起角膜溃疡需行缝线调整术,其余所有患者的眼表检测项目结果均显示不同程度的改变,但是随着术后炎症的逐渐消退,这些受影响的眼表异常均会逐渐恢复正常。泪液分泌量、泪膜破裂时间、结膜充血、瞬目次数、睑板腺功能、睫毛角度和眼睑闭合情况的影响在两个组之间均没有统计学差异(P>0.05);角膜荧光素染色在两个组之间有统计学差异(P<0.05)。结论额肌瓣悬吊术会引起患者眼表各个因素的不同程度的改变,局部用药只能改善角膜荧光素染色异常,对眼表恢复并非必要。睫毛角度异常是引起角膜损害最危险的因素。
Objective To explore the changes of ocular surface after frontal muscle flap suspension and the clinical risk factors that affect its recovery. Methods Twenty-two patients (32 eyes) with congenital blepharoptosis in frontal muscle flap suspension from January 2007 to April 2007 in Zhongshan Eye Center were randomly divided into two groups: A group and 11 cases of 16 eyes) and no local application group (B group, 11 cases of 16 eyes), the two groups were observed at 2, 5, 7 and 2 weeks after surgery in patients with tear secretion, tear film Rupture time, conjunctival hyperemia, corneal fluorescence staining, meibomian gland function, blinking times, eyelid eyelashes and eyelid closure, and analyzed whether there was a statistically significant difference between the various observations. RESULTS: Three patients (9.4% of the total number of eyes) in 2 patients (9.4% of the total number of eyes) were withdrawn from the study due to corneal epithelial edema defect. One patient (4.5%) (2 patients Eye) due to trichiasis is more serious and cause corneal ulcer sutures need to be adjusted, the rest of the patients ocular surface test results showed varying degrees of change, but with the postoperative inflammation subsided, these affected ocular surface Abnormal will gradually return to normal. There was no significant difference between the two groups in the amount of lacrimal fluid secretion, tear film rupture time, conjunctival hyperemia, blink frequency, meibomian gland function, eyelash angle and eyelid closure (P> 0.05); corneal fluorescein staining There was a significant difference between the two groups (P <0.05). Conclusions Frontal muscle flap suspension causes varying degrees of ocular surface alteration in patients. Topical application can only improve corneal fluorescein staining abnormality and is not necessary for ocular surface recovery. Abnormal eyelashes angle is the corneal damage caused by the most dangerous factor.