Wang Xiaoqiang, Chen Fengju, Tang Xin
Clinical College of Opthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin 300020, China.
Clinical College of Opthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin 300020, China. Email:
Zhonghua Yan Ke Za Zhi. 2014 Sep;50(9):687-90.
To evaluate the efficacy of two surgical treatments for conjunctivochalasis.
Prospective randomized control study. Thirty-three conjunctivochalasis patients (33 eyes) were randomly divided into two groups:simple resection group, and resection and fixation group. The former received simple conjunctival resection, and the latter received conjunctival resection and scleral fixation. Postoperative conjunctiva relaxation, BUT and ocular surface disease index (OSDI) points were compared to evaluate the efficacy of the two kinds of surgical methods.
The recurrence rate of conjunctivochalasis was 6/16 in the simple resection group and 1/17 in the resection and fixation group on month 6 after operation, and there was significant difference (P = 0.039). In 1 month, 3 months and 6 months postoperatively, the proportion of normal BUT increased respectively in both groups (simple resection group:8/16, 9/16, 10/16; resection and fixation group:8/17, 10/17, 11/17) compared with that before operation (simple resection group:3/16; resection and fixation group:4/17). The difference was statistically significant 6 months after operation compared with that before operation (simple resection group:P = 0.029; resection and fixation group:P = 0.037), but there was no statistical significance between the two groups at each time point postoperatively (P = 1.00). OSDI scores were significantly decreased in 6 months after operation in both groups (simple resection group:7.76 ± 2.42; resection and fixation group:7.21 ± 2.39) compared with those before operation (simple resection group:22.35 ± 14.68; resection and fixation group:21.83 ± 15.73). Both of the differences were statistically significant (simple resection group:t = 6.598, P < 0.01; resection and fixation group:t = 6.603, P < 0.01), but there was no statistically significant difference between the two groups on month 6 postoperatively (t = 0.647, P = 0.537).
Both conjunctival resection and conjunctival resection with sclera fixation can effectively improve symptoms, but the latter has a lower recurrence rate.
评估两种手术治疗结膜松弛症的疗效。
前瞻性随机对照研究。33例结膜松弛症患者（33只眼）随机分为两组：单纯切除术组和切除固定术组。前者接受单纯结膜切除术，后者接受结膜切除术联合巩膜固定术。比较术后结膜松弛情况、泪膜破裂时间（BUT）及眼表疾病指数（OSDI）评分，以评估两种手术方法的疗效。
术后6个月时，单纯切除术组结膜松弛症复发率为6/16，切除固定术组为1/17，差异有统计学意义（P = 0.039）。术后1个月、3个月及6个月时，两组BUT正常比例均较术前升高（单纯切除术组：8/16、9/16、10/16；切除固定术组：8/17、10/17、11/17）（单纯切除术组术前：3/16；切除固定术组术前：4/17）。术后6个月与术前相比差异有统计学意义（单纯切除术组：P = 0.029；切除固定术组：P = 0.037），但术后各时间点两组间差异无统计学意义（P = 1.00）。两组术后6个月时OSDI评分均较术前显著降低（单纯切除术组：7.76±2.42；切除固定术组：7.21±2.39）（单纯切除术组术前：22.35±14.68；切除固定术组术前：21.83±15.73）。差异均有统计学意义（单纯切除术组：t = 6.598，P < 0.01；切除固定术组：t = 6.603，P < 0.01），但术后6个月时两组间差异无统计学意义（t = 0.647，P = 0.537）。
结膜切除术和结膜切除联合巩膜固定术均能有效改善症状，但后者复发率更低。
