摘要目的 比较不同阶段圆锥角膜和正常角膜的干眼特征参数,分析各阶段圆锥角膜的干眼特征.方法 病例对照研究.选取圆锥角膜患者35例(44只眼),并按照Amsler-Krumeich分级法分为轻度圆锥角膜19只眼,中度圆锥角膜15只眼,重度圆锥角膜10只眼,选取正常角膜对照者44例(44只眼)作为正常角膜组.应用Keratograph眼表综合分析仪测量干眼特征参数:首次非侵入式泪膜破裂时间(NIBUT)、平均NIBUT、泪河高度,眼红指数及睑板腺缺失面积,同时利用眼表疾病指数问卷调查表(OSDI)对每例患者进行评分.采用f检验,Wilcoxon秩和检验,方差分析,Kruskal-Wallis H检验.结果 OSDI评分圆锥角膜组(40.96±8.15)与正常角膜组(17.98±5.50)比较,差异有统计学意义(t =10.864 P＜0.01);与正常角膜组相比,圆锥角膜组的首次NIBUT缩短(Z=3.553,P＜0.001)、平均NIBUT缩短(Z=4.373,P＜0.001)、泪河高度下降(Z=2.826,P=0.005)、眼红指数增加(Z=2.066,P=0.039),差异均有统计学意义;比较不同阶段的圆锥角膜比较中,首次NIBUT (H=16.277,P＜0.001)和平均NIBUT(H=17.033,P＜0.001)在不同阶段间的差异有统计学意义,其中中度和重度均低于轻度圆锥角膜组(P＜0.05);不同阶段圆锥角膜睑板腺缺失面积与正常人相比差异无统计学意义(F =1.555,P=0.226).结论 圆锥角膜患者具有明显的干眼症状和体征,而且圆锥角膜的不同阶段其干眼特征差异显著.

abstractsObjective To compare the dry eye characteristics of keratoconus at different stages and normal cornea.The dry eye features of keratoconus were analyzed.Methods Case-control study of 35 cases (44 eyes) of keratoconus were selected and divided into mild keratoconus 19 eyes,15 cases with moderate keratoconus and 10 eyes with severe keratoconus according to Amsler-Krumeich grading method.Forty-four cases (44 eyes) as a normal corneal group.The dry eye characteristics were measured by the Keratograph dry eye comprehensive analyzer:First noninvasive tear break up time (NIBUT),mean NIBUT,tear river height,ocular index and meibomian gland absent area.And each patient was scored using the ocular surface disease index (OSDI) questionnaire.Using the T test,Wilcoxon rank sum test,variance analysis,Kruskal-Wallis H test.Results OSDI score of keratoconus group (40.96 ± 8.15) and normal cornea group (17.98 ± 5.50),the difference was statistically significant (t =10.864,P ＜0.01).First NIBUT (Z =3.553,P ＜0.001),mean NIBUT (Z =4.373,P ＜0.001),tear height (Z =2.826,P =0.005) were significantly different from those of normal cornea (P ＜0.05).The difference between the mild keratoconus group and moderate or severe group differences was statistically significant (P ＜0.05).The difference between the two groups was not statistically significant (P ＞0.05).There was no significant difference in the area of keratoconjunctival gland between different stages (F =1.555,P =0.226).Conclusions The study parameters indicate that keratoconus patients suffer greater symptoms and signs of dry eye,the difference of dry eye at different stages of keratoconus is significant.