Li Qian, Fu Te, Yang Jun, Wang Qiao-Ling, Li Zhong-En
Department of Ophthalmology, The Second People's Hospital of Jinan, 148#, Jingyi Road, Jinan, 250001, People's Republic of China,
Graefes Arch Clin Exp Ophthalmol. 2015 Mar;253(3):431-8. doi: 10.1007/s00417-014-2882-1. Epub 2014 Dec 12.
To compare ocular surface changes after strabismus surgery with different incisions.
One hundred and twenty eyes with exotropia were randomly assigned to Group A (limbal incision) or Group B (fornix incision). Dry eye questionnaire, corneal sensitivity, tear film breakup time (TFBUT), Schirmer I test (SIT), and corneal fluorescein staining (CFS) were assessed at 1 day preoperatively and at different postoperative times.
In the A group, dry eye questionnaire scores increased and TFBUT decreased at postoperative weeks 1, 2, and 4. Corneal sensitivity decreased at postoperative weeks 1 and 2. In the B group, dry eye questionnaire scores increased and TFBUT decreased at postoperative weeks 1 and 2. Corneal sensitivity did not change. Postoperative between-group differences were significant in dry eye questionnaire scores (P = 0.0009, 1 week; P < 0.0001, 2 weeks; P = 0.0001, 4 weeks) and TFBUT (P = 0.004, 1 week; P = 0.0003, 2 weeks; P = 0.0001, 4 weeks). Between-group differences in CFS were significant postoperatively (P = 0.045, 1 week; P = 0.020, 2 weeks).
Compared to fornix incision, limbal incision results in more serious dry eye symptoms and has a greater impact on corneal sensitivity and tear film stability.
比较不同切口斜视手术后的眼表变化。
120例外斜视患者随机分为A组(角膜缘切口)和B组(穹窿部切口)。术前1天及术后不同时间评估干眼问卷、角膜敏感性、泪膜破裂时间(TFBUT)、泪液分泌试验(SIT)和角膜荧光素染色(CFS)。
A组术后第1、2和4周干眼问卷评分升高,TFBUT降低。术后第1和2周角膜敏感性降低。B组术后第1和2周干眼问卷评分升高,TFBUT降低。角膜敏感性无变化。术后干眼问卷评分(P = 0.0009,1周;P < 0.0001,2周;P = 0.0001,4周)和TFBUT(P = 0.004,1周;P = 0.0003,2周;P = 0.0001,4周)组间差异有统计学意义。术后CFS组间差异有统计学意义(P = 0.045,1周;P = 0.020,2周)。
与穹窿部切口相比,角膜缘切口导致更严重的干眼症状,对角膜敏感性和泪膜稳定性影响更大。