【摘要】目的：探讨干眼症患者手术后使用不含防腐剂的透明质酸钠和碱性成纤维细胞生长因子滴眼液的疗效。
方法：对行眼部手术的干眼症患者132例（149眼）,所行手术，眼局部用药情况、手术前、手术后药物治疗2,4wk基础泪液分泌实验和泪膜破裂时间实验的变化情况进行分析：根据病情停用抗生素激素滴眼液,术后第4wk停用透明质酸钠和碱性成纤维细胞生长因子，术后第5wk行基础泪液分泌实验和泪膜破裂时间实验。
结果：对眼科手术前、术后药物治疗2,4wk基础泪液分泌、泪膜破裂时间进行比较,差异有统计学意义（P<0.01）。
结论：干眼症患者术后使用不含防腐剂的透明质酸钠和碱性成纤维细胞生长因子滴眼液治疗，有较好疗效。
【关键词】 干眼症 泪膜破裂时间 透明质酸钠 碱性成纤维细胞生长因子 基础泪液分泌实验
INTRODUCTION
Dry eye is a kind of disease that the quantity or quality of tears are abnormal and the patients present with symptoms of burning, blurring vision, foreign body sensation and tired eyes[1]. In these years, tens of thousands of eye surgeries are performed in every country, and dry eye cases after eye surgery have been reported in the literature following surgery. (references to be written from the published data) In this article, we anlyse the results of Shirmer test I and BUT to evaluate the curative effect of sodium hyaluronate and basic fibrblast growth factor in the treatment of dry eyes after eye operation.
MATERIALS AND METHODS
One hundred and thirty two patients who underwent eye surgery, from May 2004 to April 2007, in the department of Ophthalmology, the Affiliated Hospital of Medical College of Qingdao University were subjected to Schirmer test I and BUT. Post operatively, the patients were given Oflaxacin eye drops (4 times daily) and Tobramycindexamethasone eye drops (4 times daily) and preservative free artificial tear drops and bFGF eye drops were both given 4 times daily to patients for 2 4 weeks depending the type of eye surgery performed. The Scirmer test I and BUT were done before eye surgery, and were repeated after 2 weeks and 4 weeks of post operative eye drops. The antibiotic/corticosteroid eye drops were stopped after 2 weeks or 4 weeks; and preservative free sodium hyaluronate and bFGF eye drops were stopped after 4 weeks. Then Schirmer test I and BUT were repeated after 5 weeks. The symptoms of dry eye (burning/foreign body sensation,tired eyes, blurring of vision etc) were noted during follow up of patients. The data were analyzed using SPSS 11.5 version. The results of Schirmer test I and BUT before operation and during post operative period (after 2 weeks and 4 weeks) and after 5 weeks were compared using analysis of Variance test.
RESULTS
One hundred and forty nine (149) eye surgeries were performed in 132 patients (54 males and 78 females aged between 28 and 78 years). The different surgeries performed are shown in Table 1.
The Schirmer test I results before eye surgery are diagnostic of dry eye. The difference between (t1) group and (t2) group is significant (F=2575.34, P<0.01). The difference between t (t1) group and (t3) is significant (F=1725.11, P<0.01). The difference between (t3) group and (t2) group is also significant (F=371.45, P<0.01, Table 2).
The BUT results before eye surgery are less than normal; the difference between (t1) group and (t2) group is significant (F=1356.04, P<0.01). The difference between (t1)group and (t3) group is significant (F=1013.77, P<0.01). The difference between (t3) group and (t2) group is significant (F=234.32,P<0.01,Table 3).
During the follow up, some patients defaulted. Only 105 eyes could be subjected for Schirmer test I and BUT. The sensation of discomfort disappeared and the result of the Schirmer test I was >8mm, and the BUT test was >8seconds. Then test again a week after drug withdrawal. The Schirmer test I between (t3) group and (t4) group had no statistical significance (F=43.63, P>0.05,Table 4). And the BUT tests between (t3) group and (t4) group had no statistical significance (F=38.58, P>0.05,Table 5).
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