非加热型湿房镜治疗干眼的临床疗效

目的评价湿房镜治疗干眼的临床疗效。方法自身对照临床研究。连续收集2012年11月至2013年6月期间在门诊就诊的轻中度干眼患者56例（56眼），填写干眼症状问卷、眼表疾病指数量表（OSDI）问卷，并进行眨眼频次、结膜充血程度、角膜荧光染色及泪液分泌试验（SIT）和泪膜破裂时间（BUT）测定。予配戴湿房镜1周后再次检查，内容同上。采用自身对照的配对t检验或秩和检验对治疗前后的数据进行统计学分析，并用秩和相关检验方法分析眼表保护指数（OPI）与角膜荧光染色的相关性。结果56例干眼患者配戴湿房镜1周后，干眼症状明显改善，其中干眼问卷评分（Z=-5.084，P＜0.01）及OSDI问卷评分（Z=-5.149，P＜0.01）较治疗前改善，差异有统计学意义；眨眼频次减少（t=6.430，P<0.01）；睑结膜充血（Z=-4.185，P＜0.01）、球结膜充血（Z=-2.598，P＜0.01）、角膜荧光染色（Z=-5.001，P＜0.01）及体征总分（Z=-5.288，P＜0.01）等临床体征评分明显降低，差异均有统计学意义；BUT明显增加（t=7.416，P<0.01），OPI明显增加（Z=-5.622，P＜0.01），差异具统计学意义。OPI指数与角膜荧光染色评分呈负相关（r=-0.445，P＜0.01）。结论湿房镜可有效缓解轻中度干眼患者主观症状，稳定泪膜，减轻临床体征，是干眼的有效治疗手段之一。

The clinical effects of non-heating moisture chamber glasses in the treatment of dry eye

ObjectiveTo evaluate the clinical effects of moisture chamber glasses in the treatment of dry eye. MethodsThis was a self-controlled clinical study. Fifty-six outpatients with mild to moderate dry eye were enrolled from November 2012 to June 2013. Symptoms were evaluated with a dry eye questionnaire， the ocular surface disease index （OSDI） questionnaire， blink frequency， conjunctival hyperemia， corneal fluorescein staining， Schirmer Ⅰ test （SIT）， and tear film break-up time （BUT）. The same examinations were performed after 1 week of treatment with moisture chamber glasses. Self-controlled paired t tests or rank sum tests were used for statistical analysis of the data before and after treatment. The correlation between the ocular surface protection index （OPI） and corneal fluorescein staining was analyzed by a rank correlation test. ResultsAfter one week of treatment with moisture chamber glasses， symptoms of dry eye had improved significantly based on lower scores on the dry eye questionnaire （Z=-5.084， P<0.01） and the OSDI questionnaire （Z=-5.149， P<0.01）. Meanwhile， blink frequency reduced （t=6.430， P<0.01）， palpebral conjunctival hyperemia （Z=-4.185， P<0.01） and bulbar conjunctival hyperemia （Z=-2.598， P<0.01） were alleviated， and the corneal staining score （Z=-5.001， P<0.01） and the signs score （Z=-5.288， P<0.01） were significantly reduced. In addition， moisture chamber glasses resulted in a longer BUT （t=7.416， P<0.01） and higher OPI （Z=-5.622， P<0.01）； OPI was positively correlated with corneal fluorescein staining （r=-0.445， P＜0.01）. ConclusionMoisture chamber glasses can effectively improve subjective symptoms in mild to moderate dry eye patients as well as stabilize tear film and alleviate clinical signs. It holds great potential in the treatment of dry eye.