CAJ | 학술논문

目的：探讨青光眼小梁切除手术对眼表结构及泪膜的影响。方法选择66例80只急性闭角型青光眼行小梁切除的患者，观察术前及术后6个月的角膜表面规则指数（SRI）、角膜表面非对称性指数（SAI）、角膜荧光素染色及虎红染色、基础泪液分泌试验（Schirmer I test）、泪膜破裂时间（BUT），并对数据进行统计学分析。结果小梁切除术前，术后1周、1个月、3个月和6个月的SRI为（0.26±0.11）、（0.65±0.30）、（0.53±0.25）、（0.45±0.17）和（0.28±0.12），SAI 为（0.42±0.22）、（0.78±0.23）、（0.68±0.26）、（0.60±0.22）、（0.46±0.21），术后3个月内的SRI及SAI明显增加，术后1周最明显，与术前相比差异有统计学意义（P＜0.05），术后6个月SRI及SAI与术前相比差异无统计学意义（P＞0.05）；术后1周、1个月、3个月角膜荧光素染色及虎红染色点增多，泪液分泌量明显减少、BUT明显缩短，与术前相比差异有统计学意义（P＜0.05），术后6个月角膜荧光素染色、虎红染色、SIt及BUT恢复至术前水平，与术前比差异无统计学意义（P＞0.05）。结论青光眼小梁切除术对眼表结构和泪膜具有一定程度的影响，这可能与多种因素有关，应积极采取预防措施。
목적：탐토청광안소량절제수술대안표결구급루막적영향。방법선택66례80지급성폐각형청광안행소량절제적환자，관찰술전급술후6개월적각막표면규칙지수（SRI）、각막표면비대칭성지수（SAI）、각막형광소염색급호홍염색、기출루액분비시험（Schirmer I test）、루막파렬시간（BUT），병대수거진행통계학분석。결과소량절제술전，술후1주、1개월、3개월화6개월적SRI위（0.26±0.11）、（0.65±0.30）、（0.53±0.25）、（0.45±0.17）화（0.28±0.12），SAI 위（0.42±0.22）、（0.78±0.23）、（0.68±0.26）、（0.60±0.22）、（0.46±0.21），술후3개월내적SRI급SAI명현증가，술후1주최명현，여술전상비차이유통계학의의（P＜0.05），술후6개월SRI급SAI여술전상비차이무통계학의의（P＞0.05）；술후1주、1개월、3개월각막형광소염색급호홍염색점증다，루액분비량명현감소、BUT명현축단，여술전상비차이유통계학의의（P＜0.05），술후6개월각막형광소염색、호홍염색、SIt급BUT회복지술전수평，여술전비차이무통계학의의（P＞0.05）。결론청광안소량절제술대안표결구화루막구유일정정도적영향，저가능여다충인소유관，응적겁채취예방조시。
Objective To evaluate the effects of trabeculectomy in glaucoma on eye surface structures and tear iflm. Methods 80 eyes of 66 cases with acute angle-closure glaucoma were studied. The symptoms and signs were observed preoperatively and 6 months postoperatively, such as surface regularity index (SRI), surface asymmetry index (SAI), lfuorescein staining of corneal and rosebengal staining , Schirmer I test (SIt) and tear break up time(BUT). The results were all analyzed. Results Before surgery, 1 weeks, 1 months, 3 months and 6 months after trabeculectomy. The SRI’ scores were (0.26±0.11), (0.65±0.30), (0.53±0.25), (0.45±0.17), (0.28 ±0.12), the SAI’ scores were (0.42±0.22), (0.78±0.23), (0.68±0.26), (0.60±0.22), (0.46±0.21), respectively. SRI and SAI were significantly increased in 3 months postoperation compared with preoperation (P<0.05), espically in 1 week postoperation, while there were no signiifcant difference between 6 months postoperation and preoperation (P>0.05). FSC’ and SC’ scores were signiifcant increased in 1 week, 1 month, 3 months postoperation compared with preoperation (P<0.05). SIt’ scores and BUT’ times were all signiifcantly decreased in 3 months postoperation compared with preoperation. All of the signs were no signiifcant difference between 6 months postoperation and preoperation (P>0.05). Conclusion Trabeculectomy in glaucoma does have some effects on the ocular surface structures and tear iflm, which is related to multi-factors. Clinical preventions should be taken.