新月形结膜切除联合巩膜浅层烧灼术治疗结膜松弛症的临床研究

Clinical study on conjunctivochalasis with crescent shaped conjunctival resection combined with on superficial sclera operation

关键词:  结膜松弛症  新月形结膜切除  巩膜浅层烧灼术

Key words:  conjunctivochalasis  crescent shaped conjunctival resection  cauterization on superficial sclera

摘要:

目的　探讨新月形结膜切除联合巩膜浅层烧灼术治疗结膜松弛症的有效性和稳定性。　方法　将84只眼（50例患者）结膜松驰症随机分为两组，单纯新月形结膜切除术组和新月形结膜切除联合巩膜浅层烧灼术组。检测患者术后1 d、3 d、7 d、1个月、3个月、6个月、9个月、12个月的泪河高度和泪膜破裂时间，并比较两组间术后各时间点的差异及各组术后各时间点与术前的差异。　结果　两组手术前与手术后各时间段泪河高度和泪膜破裂时间的差异均有显著性意义(P<0.05)。术后12个月时，泪膜破裂时间：单纯新月形结膜切除术组为（9.21±3.48）s，新月形结膜切除联合巩膜浅层烧灼术组为（13.81±4.56）s，差异有显著性意义(P<0.05)；泪河高度两组分别为：（246±67）μm和（279±92）μm，差异有显著性意义 (P<0.05)。　结论　新月形结膜切除术与新月形结膜切除联合巩膜浅层烧灼术治疗结膜松弛症效果均显著，但后者治疗结膜松驰症具有更好的稳定性。

Abstract:

Objective To study the effectiveness and stability of crescent shaped conjunctival resection combined with cauterization on superficial sclera operation of conjunctivochalasis. Methods Eighty-four eyes (fifty patients) were randomly divided into two groups: crescent shaped conjunctival resection group and the crescent shaped conjunctival resection combined with cauterization on superficial sclera group. The patients were followed up preoperatively and postoperatively at 1 day，3 day，7 day，1 month，3 month，6 month，9 month and 12 month for measuring Tear meniscus height and break-up time of tear film (BUT) before and after surgery. Results The height of tears river and break-up time of tear film (BUT) postoperatively in two groups were significantly higher than those of pre-operation (P<0.05). BUT of the two groups were (9.21±3.48) seconds and (13.81±4.56) seconds and Tear meniscus height of the two groups were (246±67)μm and (279±92)μm respectively at 12 months postoperatively. The surgical effect of crescent shaped conjunctival resection combined with cauterization on superficial sclera group was higher significantly than that of the crescent shaped conjunctival resection group in the 12th month post-operation (P<0.05). Conclusion Both crescent shaped conjunctival resection and crescent shaped conjunctival resection combined with cauterization on superficial sclera operation can improve symptoms of conjunctivochalasis significantly. The crescent effect of the latter operation has better stability.