【摘要】 目的利用Keratograph眼表综合分析仪分析使用局部抗青光眼药物的老年患者的眼表状况。方法 59例(71只眼)原发性青光眼患者纳入研究,均为局部使用降眼压眼药的老年患者。应用Keratograph眼表综合分析仪测量非侵入性泪膜破裂时间(NI-TBUT-f)、平均非侵入性泪膜破裂时间(NI-TBUT-ave),泪河高度(TMH),同期获取干眼分级、睑板腺分级、脂质层分级结果,并行角膜荧光素钠染色检查。统计各项指标的数据结果,比较不同性别间的差异,并对各指标间的相关性进行分析。结果 1.NI-TBUT-f 1.91~10.90 s,(4.89±2.41)s;NI-TBUT-ave 2.48~14 s,(7.98±2.79)s;干眼分级,2级(干眼)26只眼(37.0%)。TMH0.07~0.37 mm,(0.22±0.10)mm,TMH<0.2 mm者35只眼(49.0%)。睑板腺照相评价,睑板腺无缺失者1只眼(1.4%),睑板腺缺失<1/3者28只眼(39.4%),睑板腺缺失1/3~2/3者26只眼(36.6%),睑板腺缺失>2/3者16只眼(22.5%)。脂质层分级,I、II级(正常)56只眼(79.0%);III、IV、V级(异常)15只眼(21.0%)。角膜荧光素染色,染色阴性者16只眼(23.0%),染色阳性者55只眼(77.0%)。2.不同性别间用药种类大致相同(P>0.05),各指标差异均无统计学意义(P>0.05)。3.Pearson相关分析结果显示,NI-TBUT-f和NI-TBUT-ave呈正相关(r=0.573,P<0.001),TMH与NI-TBUT-f无相关性(r=-0.022,P=0.858),TMH与NI-TBUT-ave亦无相关性(r=0.058,P=0.631)。结论局部使用抗青光眼药物的老年患者是干眼的高危人群,利用眼表分析仪早期发现并积极干预可以提高此类患者对抗青光眼药物治疗的依从性。更多还原

【Abstract】 OBJECTIVE To evaluate the ocular surface of senile patients on Topical glaucoma therapy by Keratograph ocular surface analyzer. METHODS A total of 59 senile patients(71 eyes) on topical glaucoma therapy were included in the study. The first noninvasive tear film break-up time(TBUT-f), the average noninvasive tear film break-up time(TBUT-ave), the tear meniscus height(TMH), the meibomian glands score, lipid layer analysis and corneal fluorescein staining were tested by the Keratograph ocular surface analyzer. The data were statistically studied. RESULTS 1.NI-TBUT-f1.91～10.90 s,(4.89±2.41)s; NI-TBUT-ave 2.48～14 s,(7.98±2.79)s; Dry eye grading: grade II dry eye 26 eyes(37.0 %). TMH was 0.07 ~ 0.37 mm,( 0.22±0.10) mm, and 35 eyes(49.0 %) were less than 0.2 mm in TMH. According to the evaluation of meibomian gland photography, there was 1 eye(1.4 %) without meibomian gland loss, 28 eyes(39.4 %) with meibomian gland loss less than one third, 26 eyes(36.6%) with meibomian gland loss between one third and two thirds and 16 eyes(22.5 %) with meibomian gland loss more than two thirds. Lipid layer classification: Fifty-six eyes(79.0 %) were in grade I and II(normal); Fifteen eyes(21.0%) were classified in III, IV or V(abnormal). Corneal fluorescein staining showed that 16 eyes were negative(23.0%) and 55 eyes were positive(77.0%). 2. The effects of different drug types were basically the same(P> 0.05), and there was no significant difference among all indicators(P >0.05).3. Pearson correlation analysis showed that NI-TBUT-f and NI-TBUT-ave were positively correlated(r =0.573, P <0.001), TMH had no correl ation with NI-TBUT-f(r=-0.022, P=0.858), and TMH had no correlation with NI-TBUT-ave(r=0.058, P=0.631).CONCLUSIONS The patients on glaucoma therapy were more susceptible to dry eye symptoms,and early diagnosis and intervention with Keratograph ocular surface analyzer were useful for improving their compliance.更多还原