Upper Punctal Occlusion versus Lower Punctal Occlusion in Dry Eye
Upper Punctal Occlusion versus Lower Punctal Occlusion in Dry Eye
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DOI：
10.1167/iovs.09-5097
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发表时间：
2010-11-01
影响因子：
4.4
通讯作者：
Lu, Fan
中科院分区：
文献类型：
--
作者：
Chen, Feng;Wang, Jianhua;Lu, Fan
目的.比较上泪点阻塞与下泪点阻塞治疗干眼症的疗效。对20例干眼患者的一只眼的上泪点和对侧眼的下泪点用胶原塞封闭。在20名正常受试者中进行相同的程序。在泪点阻塞前通过实时OCT同时对上、下泪腺进行成像，并在阻塞后第1、4、7和10天重复。观察两组患者的主观症状评分、角膜荧光素染色强度、泪液分泌试验结果及泪膜破裂时间（TBUT）。在干眼患者中，阻塞任一泪点可改善症状评分、荧光素染色评分、TBUT和下泪半月板高度（LTMH，P < 0.05），但Schirmer试验评分和上泪半月板高度（UTMH）在阻塞后无变化（P > 0.05）。上泪点阻塞眼与下泪点阻塞眼在阻塞前后上述各项指标均无显著性差异（P > 0.05）。在正常受试者中，Schirmer试验评分、TBUT、UTMH和LTMH不随时间变化（P > 0.05）。干眼患者用胶原塞进行泪点阻塞可缓解主观症状，改善客观体征。阻塞上泪点或下泪点的效果相似。LTMH是泪点阻塞成功的有效指标。（Invest Ophthalmol维斯科学。2010;51：5571-5577）DOI：10.1167/iovs.09-5097
PURPOSE. To compare the effectiveness of upper punctal occlusion versus that of lower punctal occlusion in dry eye patients.METHODS. One eye's upper punctum and the contralateral eye's lower punctum were occluded with collagen plugs in 20 dry eye patients. The same procedure was performed in 20 normal subjects. The upper and lower tear menisci were imaged simultaneously by real-time OCT before punctal occlusion and repeated on days 1, 4, 7, and 10 afterward. The subjective symptom score, corneal fluorescein staining intensity, Schirmer I test result, and tear breakup time (TBUT) were also determined.RESULTS. In dry eye patients, occlusion of either punctum improved symptom scores, fluorescein staining scores, TBUT, and lower tear meniscus height (LTMH, P < 0.05); however, Schirmer test scores and upper tear meniscus height (UTMH) did not change after occlusion (P > 0.05). There was no significant difference for any of these variables between upper punctum-and lower punctum-occluded eyes, before or after occlusion (P > 0.05). In normal subjects, Schirmer test scores, TBUT, UTMH, and LTMH did not change over time (P > 0.05).CONCLUSIONS. Punctal occlusion with collagen plugs in dry eye patients leads to the relief of subjective symptoms and the improvement of objective signs. The effectiveness of occluding the upper or lower punctum is similar. The LTMH is a valid indicator of the success of punctal occlusion. (Invest Ophthalmol Vis Sci. 2010;51:5571-5577) DOI: 10.1167/iovs.09-5097