老年功能性泪溢患者下睑松弛矫正术后泪膜和泪液蛋白的特点

摘要

Objective To observe the symptom of ocular surface,tear film and tear protein of the elderly functional epiphora patients after lower eyelid relaxation.Methods Sixty elderly functional epiphora patients caused by loose lower lid(60 eyes) were randomly divided into two groups:( group A) the lateral tarsal strip,( group B) Kuhnt tarsal triangular resection.The symptom of ocular surface,tear film and tear protein examination were performed at 1 week,1 months and 3 months postoperatively.Results Effective rate of group A was 90.0%, which was higher than that of group B(70.0%)(P<0.05).There were no significant differences for the symptom score of ocular surface,OS-DI,BUT,ST,tear meniscus height,FL tear proteins,lactoferrin,lysozyme and sIgA between two groups preoperatively(P>0.05).There were statistical significance for ST,tear meniscus height and FL at postoperative week 1 in both groups(P<0.05),whereas no statistical signifi-cance for symptom of ocular surface,OSDI,BUT,tear proteins,lactoferrin,lysozyme and sIgA (P>0.05).There were statistical significance for OSDI,BUT,ST,tear meniscus height and FL at postoperative month 3 in both groups(P<0.05),whereas no statistical significance for symptom of ocular surface,tear proteins,lactoferrin,lysozyme and sIgA (P>0.05).Conclusions The lateral tarsal strip is a more favorable solution for the elderly functional epiphora patients caused by loose lower lid,which could ameliorate the symptom of ocular surface and tear film function,increase the tear protein and therefore improve the visual quality.%目的：探讨老年功能性泪溢患者（ FE）下睑松弛矫正术后眼表症状及泪膜和泪液蛋白的特点。方法筛选下眼睑松弛导致的老年FE患者60例（60只眼），随机分为两组： A组行外侧睑板条悬吊术；B组行Kuhnt睑板三角切除术，分别于术前、术后1 w、1个月及3个月对患者行眼表症状评分、泪膜四项检查和泪液各蛋白测定。结果 A组总有效率为90.0％，B组70.0％，两组比较差异有统计学意义（P＜0.05）；术前两组患者干眼各亚症状评分、眼表指数（OSDI）、泪膜破裂时间（BUT）、基础泪液分泌试验（ST）、泪河高度、角膜荧光素染色（FL）、泪液蛋白、乳铁蛋白、溶菌酶和分泌型免疫球蛋白A（sIgA）差异无统计学意义（P＞0.05）；术后1 w，两组患者ST、泪河高度、FL比较差异均有统计学意义（P＜0.05），但两组眼表各症状、OSDI、BUT、泪液总蛋白量、乳铁蛋白、溶菌酶及sIgA之间比较均无统计学差异（P＞0.05）；术后3个月，两组患者OSDI、BUT、ST、泪河高度、FL有统计学差异（ P＜0.05），但两组眼表各症状、泪液总蛋白量、乳铁蛋白、溶菌酶及sIgA差异无统计学意义（ P＞0.05）。结论对于下眼睑松弛导致的老年FE患者，外侧睑板条悬吊术可以明显改善患者眼表症状、泪膜情况，同时可升高泪液蛋白，提高患者的视觉质量。