Sun Qi, Wang Yi, Zhou Yi-long, Zhou Li-qin, Mo Bai-jun
Department of Ophthalmology, the First Hospital of Jiaxing, Jiaxing 314000, China.
Zhonghua Yan Ke Za Zhi. 2010 May;46(5):405-9.
To investigate the efficacy for treating conjunctivochalasis with conjunctival positioning and quantified patch.
It was a case-control study. A case-control study of 30 patients from the First Hospital of Jiaxing from 2007 to 2008 with binocular conjunctivochalasis. Every patient was treated one eye with simple logadectomy while the other eye with positioning and quantified logadectomy randomly. Subjective and objective evaluations were taken on the 1st, 3rd and 6th months post-operation. Subjective evaluations include effective rate and cure rate. Objective evaluations include slit-lamp biomicroscope morphological variety, tear meniscus height, break-up time (BUT), Schirmer I test (SIT), fluorescein stain test (Fl), the first fluorescein stain. Cure rate and efficacy rate were compared in two groups with chi-square test.
Subjective evaluations were on the 1st month post-operation. There were 5 eyes (16.7%) curing, 13 eyes (43.3%) improved, 12 eyes (40.0%) ineffective in simply logadectomy group; While there were 12 eyes (40.0%) curing, 16 eyes (53.3%) improved, 2 eyes (6.7%) ineffective in the positioning and quantified logadectomy group. The effective rate (chi2=9.317, P<0.01) and cure rate(chi2=4.022, P<0.05)had statistic significance. Effective rate in simply logadectomy group was increasing gradually on the 3rd and 6th month post-operation while effective rate in positioning and quantified logadectomy group was stable. But the effective rate in this group was still higher than the simple logadectomy group. To objectively evaluate the cure rate on the 1st month post-operation: slit-lamp biomicroscope morphological variety: there were 10 eyes turn to normal in simply logadectomy group while 29 eyes (chi2=26.447, P<0.01) in the positioning and quantified logadectomy group. Tear meniscus height: there were 18 eyes turn to normal in simply logadectomy group while 30 eyes (chi2=15.000, P<0.01) in the positioning and quantified logadectomy group. BUT: There were 12 eyes turn to normal in simply logadectomy group while 28 eyes (chi2=19.200, P<0.01) in the positioning and quantified logadectomy group. SIT: there were 18 eyes turn to normal in simply logadectomy group while 25 eyes (chi2=4.022, P<0.05) in the positioning and quantified logadectomy group. Fl: there were 20 eyes turn to normal in simply logadectomy group while 28 eyes (chi2=6.667, P<0.05) in the positioning and quantified logadectomy group. The first fluorescein stain: there were 12 eyes turn to normal in simply logadectomy group while 24 eyes (chi2=10.000, P<0.01) in the positioning and quantified logadectomy group. The difference had statistic significance. On the 3rd month post-operation: SIT: there were 18 eyes turn to normal in simply logadectomy group while 19 eyes (chi2=0.071, P>0.05) in the positioning and quantified logadectomy group, without statistic significance. All the other objective evaluations indicatrix had statistic significance. On the 6th month post-operation: SIT: there were 20 eyes turn to normal in simply logadectomy group while 21 eyes (chi2=0.077, P>0.05) in the positioning and quantified logadectomy group, without statistic significance. Fl: there were 23 eyes turn to normal in simply logadectomy group while 28 eyes (chi2=3.268, P>0.05) in the positioning and quantified logadectomy group, without statistic significance. All the other objective evaluations indicatrix had statistic significance.
Positioning and quantified patch resection method not only makes it easier and safer for treating the conjunctivochalasis, but also reduces the complications and creates good result for patients in early period.
探讨结膜定位定量切除术治疗结膜松弛症的疗效。
采用病例对照研究。选取2007年至2008年嘉兴市第一医院收治的30例双眼结膜松弛症患者为研究对象。每位患者一只眼行单纯睑裂斑切除术,另一只眼随机行定位定量睑裂斑切除术。术后第1、3、6个月进行主观和客观评估。主观评估包括有效率和治愈率。客观评估包括裂隙灯显微镜形态变化、泪膜半月高度、泪膜破裂时间(BUT)、泪液分泌试验(SIT)、荧光素染色试验(Fl)、首次荧光素染色。采用卡方检验比较两组的治愈率和有效率。
术后第1个月主观评估:单纯睑裂斑切除术组治愈5眼(16.7%),好转13眼(43.3%),无效12眼(40.0%);定位定量睑裂斑切除术组治愈12眼(40.0%),好转16眼(53.3%),无效2眼(6.7%)。有效率(χ2=9.317,P<0.01)和治愈率(χ2=4.022,P<0.05)有统计学意义。单纯睑裂斑切除术组术后第3、6个月有效率逐渐升高,定位定量睑裂斑切除术组有效率稳定,但该组有效率仍高于单纯睑裂斑切除术组。术后第1个月客观评估治愈率:裂隙灯显微镜形态变化:单纯睑裂斑切除术组10眼恢复正常,定位定量睑裂斑切除术组29眼(χ2=26.447,P<0.01)。泪膜半月高度:单纯睑裂斑切除术组18眼恢复正常,定位定量睑裂斑切除术组30眼(χ2=15.000,P<0.01)。BUT:单纯睑裂斑切除术组12眼恢复正常,定位定量睑裂斑切除术组28眼(χ2=19.200,P<0.01)。SIT:单纯睑裂斑切除术组18眼恢复正常,定位定量睑裂斑切除术组25眼(χ2=4.022,P<0.05)。Fl:单纯睑裂斑切除术组20眼恢复正常,定位定量睑裂斑切除术组28眼(χ2=6.667,P<0.05)。首次荧光素染色:单纯睑裂斑切除术组12眼恢复正常,定位定量睑裂斑切除术组24眼(χ2=10.000,P<0.01)。差异有统计学意义。术后第3个月:SIT:单纯睑裂斑切除术组18眼恢复正常,定位定量睑裂斑切除术组19眼(χ2=0.071,P>0.05),无统计学意义。其他所有客观评估指标均有统计学意义。术后第6个月:SIT:单纯睑裂斑切除术组20眼恢复正常,定位定量睑裂斑切除术组21眼(χ2=0.077,P>0.05),无统计学意义。Fl:单纯睑裂斑切除术组23眼恢复正常,定位定量睑裂斑切除术组28眼(χ2=3.268,P>0.05),无统计学意义。其他所有客观评估指标均有统计学意义。
定位定量切除术治疗结膜松弛症不仅操作简便、安全,还可减少并发症,早期疗效良好。