CAJ | 학술논문

目的探讨穿透性角膜移植术后泪膜稳定性的变化规律.方法对20例行部分穿透性角膜移植术后的患者分别观察术后6、9、12个月主观感觉、泪膜破裂时间(BUT)、泪液分泌值、泪河高度值、角膜荧光素染色,并与健眼对照观察.将结果作统计学分析.结果穿透性角膜移植术后12个月内,术眼泪膜破裂时间低于健眼(P＜0.01),但患者无明显眼部干涩等症状;泪液分泌值在6个月时,比较健眼有统计学意义(P＜0.01),9、12个月时与健眼相比无统计学意义(P＞0.05);泪河高度值在6个月时比较健眼有统计学意义(P＜0.01),9、12个月时术眼与健眼无统计学意义(P＞0.05);荧光素染色在6个月时评分为7.89,与健眼比较有统计学意义(P＜0.01),9、12月时评分为4.62、3.03,与健眼比较无统计学意义(P＞0.05).结论穿透性角膜移植术后6～12月的时间内,术跟的泪膜稳定性仍未恢复到正常水平,特别是泪膜破裂时间的缩短较健眼有显著差异(P＜0.01),提示穿透性角膜移植术后12个月时间内,存在泪膜不稳定和干眼症,需要定期复查泪膜变化,根据情况使用不含防腐剂的人工泪液和角膜营养,神经营养药物.
목적 탐토천투성각막이식술후루막은정성적변화규률.방법 대20례행부분천투성각막이식술후적환자분별관찰술후6、9、12개월주관감각、루막파렬시간(BUT)、루액분비치、루하고도치、각막형광소염색,병여건안대조관찰.장결과작통계학분석.결과 천투성각막이식술후12개월내,술안루막파렬시간저우건안(P＜0.01),단환자무명현안부간삽등증상;루액분비치재6개월시,비교건안유통계학의의(P＜0.01),9、12개월시여건안상비무통계학의의(P＞0.05);루하고도치재6개월시비교건안유통계학의의(P＜0.01),9、12개월시술안여건안무통계학의의(P＞0.05);형광소염색재6개월시평분위7.89,여건안비교유통계학의의(P＜0.01),9、12월시평분위4.62、3.03,여건안비교무통계학의의(P＞0.05).결론 천투성각막이식술후6～12월적시간내,술근적루막은정성잉미회복도정상수평,특별시루막파렬시간적축단교건안유현저차이(P＜0.01),제시천투성각막이식술후12개월시간내,존재루막불은정화간안증,수요정기복사루막변화,근거정황사용불함방부제적인공루액화각막영양,신경영양약물.
Objective To investigate tear film changes after penetrating keratoplasty. Methods Twenty cases (20eyes)after penetrating keratoplasty were examined. We observed subjective symptom, tear fill bread-up time, Schirmer Test Ⅰ with anaesthesia, the height of tear meniscus and corneal fluorescein staining. On both operative eye and healthy eye of the patients at 6m, 9m, 12m after penetrating keratoplasty. Then the results were analysis in statistics.Results During 6m after penetrating keratoplasty the data of tear film break-up time of the operative eye was less than the healthy eye(P＜0,01 ). But the patients didn't feel dull and dry; the data of Schirmer Test Ⅰ with anaesthesia of the operative eye was significantly different from the healthy eye at 6m after penetrating keratoplasty (P＜0.01 ). There was no significant difference between operative eye and healthy eye at 9m and 12m (P＞0.05 ). FL scored at 7.89 in operative eye at 6m was significantly different from FL in healthy eye(P＜0.01 ). FL scored at 4.62,3.03 in operative eye at 9m and 12m wasn't different from FL in healthy eye (P＞0.05). Conclusions During the time from 6 months to 12 months after penetrating keratoplasty, the tear film stability does not get resume, especially the shorten of tear film break-up time had significant difference between operation eye and healthy eye (P＜0.01)Indicating instability of tear film and transient dry eye was existed during one year after penetrating keratoplasty.Patients should examine the change of tear film regularly, use artificial tears without antiseptics and medcime with cormeal nutrition and nerve nutrition.