目的：对比两种不同部位M22优化脉冲激光治疗方法治疗睑板腺功能障碍(meibomian gland dysfunction，MGD)所致干眼的疗效。方法：回顾性分析汕头博德眼科医院干眼门诊患者105例，包括常规治疗组和改良治疗组两个组别，常规治疗组激光部位为下睑，改良治疗组激光部位为联合上下睑，所有患者行M22优化脉冲光治疗一个疗程(每月1次，共3次)，治疗前后均采用keratograph 5M干眼分析仪分析评估患者的泪河高度情况、泪膜破裂时间(break-up time，BUT)、角膜荧光染色(corneal fluorescence staining，CFS)和睑板腺排出能力等参数。采用t检验分析对比治疗前后变化情况。结果：患者治疗后泪河高度较强脉冲光治疗前明显增高，BUT时间延长，角膜荧光染色和睑板腺排出能力评分均有好转，每组治疗后与治疗前差异有统计学意义(P<0.01)，两组间治疗前后各参数差异比较均没有统计学意义。结论：两种不同部位M22优化脉冲激光治疗方法在治疗MGD导致的干眼方面有较好的效果，是较安全有效地治疗方法，两种不同方法治疗效果无明显差异。
Objective: To study the efficacy of two methods of M22 optimal pulsed technology in the treatment of dry eye caused by meibomian gland dysfunction (MGD). Methods: A total of 105 patients collected from Shantou Balder Eye Hospital were divided into two groups. The treatment position of the conventional group was lower eyelid, the other group was combined with upper and lower eyelid. All patients accepted M22 Optimal Pulsed Technology treatment for three times, once a month. Keratograph 5M dry eye analyzer was used to assess the height of tears river, break-up time (BUT), corneal fluorescence Staining(CFS)and meibomian gland expressibility. The results before and after laser treatment were compared using t-test in this study. Results: After treatment, the height of tear river, BUT, CFS and meibomian gland expressibility were improved. There was a statistically significant difference between each group after and before treatment (P<0.01). There was no significant difference before and after treatment between the two groups. Conclusion: The two methods of M22 Optimal Pulsed Technology are effective in treating dry eyes caused by MGD. There is no significant difference in the therapeutic effect between two methods.
本文对7例正常人眼前房角小梁网进行了组织化学——酸性粘多糖及超微结构的研究。结果表明人类正常眼前房角小梁中存在酸性粘多糖,以内皮网处较多,大部分可被透明质酸酶消化。小梁带中螺旋纤维可能是小梁网柔韧性的结构基础,小梁带基板层与小梁带内皮细胞胞浆存在密切联系,小梁内皮细胞间的连接,可能对防止小梁带受外界因素影响而发生位移有一定稳固作用,内皮网间质中存在Ⅰ、Ⅱ型斑状物及胶原成分,39岁以下眼中含量较少,老年眼中较多。Schlemm 氏管内壁内皮细胞胞浆中液泡是房水排出的细胞内途径,证实了本文作者1963年提出的论点。
Histochemical and ultrastructural studies of the trabecular meshwork (TM) of 7 normal human eyes were carried out. The age of this group ranged between 20-70 years. Histochemical results showed that acid mucopolysaccharides existed in the TM of normal eyes, especially in the endothelial meshwork portion. Most of the acid mucopoly-saccharides were digestible by testicular hyaluronidase. The ultrastructural study indicated the following: 1. The spiral fibrils surrounding the collagen core of TM were spaced unequally in spiral distance and might wind loosely or tightly. This structure might be the anatomic basis of the flexibility of the trabeculae, 2. The discontinuous cytoplasmic membrane of the endothelium and the extention of the basal lamina to the endothelial cytoplasm as a process-like structure might imply that there were substances exchanged between the endothelial cells and the basal lamina of the trabeculae. 3. The structures known as tongue-in-groove and interdigitation joints were desmosomes or gap junctions between the adjacent cell membrane. These two junctional structures might act as stabilizers to prevent trabecular bands from moving when effected by outer environment. 4. The vacuoles within the cytoplasm of the endothelial cell lining the inner wall of Schlemm's canal might indicate that the aqueous outflow passes through intracellular path-way. This evidence confirmed our suggestion in 1963 which is consistent with many authors' idea.
