摘要
目的观察高血压患者微创玻璃体视网膜手术后泪膜变化。方法前瞻性病例系列研究。行微创玻璃体视网膜手术的133例患者133只眼纳入研究。其中，伴高血压病的47例47只眼作为A组，无高血压病的86例86只眼作为B组；均以未手术眼作为对照。手术前1d，手术后1、3、10d，1、3个月行不适症状评分、泪膜破裂时间（BuT）、角膜荧光素染色（CFS）评分及基础泪液分泌试验（SIT）检查。数据采用Wilcoxon秩和检验、Kruskal—Walli检验、单因素方差分析和独立样本t检验进行处理。结果两组对照眼各时间点CFS评分、BUT比较，差异均无统计学意义（Z=-3．229，-2．780，-2．018，-2．379，-3．374，-3．213；f--2．452，-2．963，-2．580，-3．018，-2．339，-2．374；P〉0．05）。两组手术眼手术前1d、手术后10dSIT长度之间检测结果比较，差异均有统计学意义（t--4．668，-5．384；P％0．05）。与手术前相比，A组手术眼手术后1、3dCFS评分差异有统计学意义（Z--5．229，-4．780；P〈0．05）；手术后1、3dBUT差异有统计学意义（t=-5．633，-4．884；P％0．05）；手术后1dSIT长度差异有统计学意义（t=-4．743，P〈0．05）。手术后1、3d，患者均未感到手术眼明显不适，19例患者主诉略有痛痒感及眼红，占14％；手术眼各时间点CFS评分比较，差异均无统计学意义（Z=3．123，-3．730，-2．198，-3．379，-3．434，-2．393；P〉0．05）；手术后1、3dBUT比较，差异有统计学意义（t=-5．537，-5．014；P〈0．05）；手术后1、3dSIT长度比较，差异均有统计学意义（t=-3．653，-4．371；P〈0．05）。结论高血压患者泪膜稳定性差。微创玻璃体视网膜手术后泪膜稳定性和泪液分泌量下降；泪膜恢复较慢。
Objective To observe the changes in tear film after minimal vitreoretinal surgery in patients with hypertension. Methods One hundred and thirty-three eyes of 133 patients （47 patients with systemic hypertension as group A and 86 eyes without systemic hypertension as group B） underwent 23- gauge or 25-gauge vitreous microsurgery were enrolled in this study. The contralateral eyes were regarded as the control group. Uncomfortable symptoms score, break-up time （BUT）, Schirmer＇s I test （S I T） and corneal fluorescein staining （CFS） were recorded before and after surgery in all patients. Data were analyzed with a Wilcoxon rank sum test, Kruskal-Wallis one-way ANOVA and independent samples t test. Results Comparison between non-surgery eyes of group A and group B indicated no statistical difference in CFS and BUT score at each follow-up （Z=-3. 229, -2. 780, -2. 018, -2. 379, -3. 374, -3. 213： t=-2. 452, -2. 963, -2.580, -3.018, -2.339, -2.374; P〈0.05）. However, statistical difference of S I T between the two groups was found either 1 day before surgery or 10 days after surgery （t = - 4. 668, -5. 384; P〈0.05）. Comparing the CFS and BUT in group A at 1, 3 days after operation with 1 day before surgery, the differences were statistically significant （Z = - 5. 229, - 4. 780; P 〈 0.05; t = - 5. 633, -4. 884; P= 0. 001）. The statistical significance was noticed in S I T between 1 day before surgery and 1 day after surgery （t = - 4. 743, P = 0. 001）. Comparison between uncomfortable symptoms scores of operated eyes in group A and group B revealed no significant difference between 1 and 3 days after surgery. Nineteen patients （14%） complained of pain and red eye. ,There was no statistical difference between CFS score at each follow-up （Z=-3.123, -3. 730, -2. 198, -3. 379, -3. 434, -2. 393; P〉0.05）. There were significant differences between BUT scores of operated eyes in two groups at 1 and 3 days after operation
（t=-5. 537, -5. 014 P〈0.05）. There was also a significant statistical difference between S I T 1 and 3 days after operation between groups （t=-3. 653, -4. 371; P〈0.05）. Conclusions The stability of tear film in hypertension patients is poorer than normal patients. The secretion of tears in hypertension patients declines and the tear film recovers slowly after the surgery.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2012年第2期145-148,共4页
Chinese Journal of Ocular Fundus Diseases
关键词
玻璃体切除术/副作用
外科手术
微创性
高血压
眼泪/代谢
Vitrectomy/adverse effects
Surgical procedures, minimally invasive
Hypertension Tears/metabolism
