刘俐 陈峰

[摘要]目的利用 Oculus 眼表分析儀研究恒定性外斜视患儿的眼表状况，并探索斜视度数与眼表状态的相关性。方法回顾性分析南方医科大学顺德医院2019年4月至2021年5月收治的2～7岁恒定性外斜视患儿68例，使用 oculus 眼表分析仪进行泪河高度、非侵入式泪膜破裂时间、眼红指数分析及脂质层检测。根据检查结果分为主斜眼组（68只眼）与非主斜眼组（68只眼），比较两组泪河高度、均眼红指数、颞侧眼红指数、鼻侧眼红指数、脂质层等指标。结果主斜眼与非主斜眼间泪河高度比较，差异无统计学意义（P >0.05）;非主斜眼组第一次 NIBUT（8.77±2.94）s、平均 NIBUT（12.13±4.50）s 高于主斜眼组的（6.59±2.63）s、（9.16±3.72） s，差异有统计学意义（P <0.05）。主斜眼组与非主斜眼组的平均眼红指数比较，差异无统计学意义（P >0.05），颞侧眼红指数比较，差异无统计学意义（ P >0.05）;非主斜眼组鼻侧结膜眼红指数（1.24±0.56），低于主斜眼组的（1.59±0.56），差异有统计学意义（ P <0.05）。主斜眼组与非主斜眼组的脂质层差异有统计学意义（ P <0.05）;恒定性外斜视患者的泪河高度及平均眼红指数与斜视度无相关性 ， 与第一次 NIBUT 及平均 NIBUT 呈负相关。结论恒定性外斜视患儿术前就存的眼表异常和水样层无关，与脂质层改变有关，并且斜视度数越大，泪膜越不稳定。对于斜视患儿，尤其是较大度数斜视患儿，应指导其正确眨眼，优先使用含脂质的人工泪液。

[关键词]恒定性外斜视;泪液;眼表;斜视度;相关性

[中图分类号] R77 [文献标识码] A  [文章编号]2095-0616（2021）22-0188-04

Study on the association between ocular surface condition and strabismus angle in children with constant exotropia

LIU  Li   CHEN  Feng

Department of Ophthalmology， Shunde Hospital of Southern Medical University （the First People's Hospital of Shunde District in Foshan City）， Guangdong， Foshan 528308， China

[Abstract] Objective To study the ocular surface condition of children with constant exotropia by Oculus ocular surface analyzer， and to explore the correlation between strabismus angle and ocular surface condition. Methods A total of 68 children with constant exotropia aged 2-7 years old who were admitted to Shunde Hospital of Southern Medical University from April 2019 to May 2021 were analyzed retrospectively. The Oculus ocular surface analyzer was used to analyze the tear meniscus height （TMH）， non-invasive tear break-up time （NIBUT） and hyperemia index， and to detect the lipid layer. According to the examination results， they were divided into main squint group（68 eyes） and non-main squint group（68 eyes）. The TMH， average hyperemia index， hyperemia index at temporal side， hyperemia index at nasal side and lipid layer were compared between the two groups. Results There was no significant difference in TMH between main squint and non-main squint （P >0.05）. The first NIBUT and average NIBUT in the non-main squint group （8.77±2.94） s， （12.13±4.50） s were higher than those in the main squint group （6.59±2.63） s and （9.16±3.72） s， and the differences were statistically significant （P <0.05）. There were no significant differences in the average hyperemia index and hyperemia index at temporal side between the main squint group and the non-main squint group （P >0.05）. The hyperemia index at nasal side in the non-main squint group （1.24±0.56） was lower than that in the main squint group （1.59±0.56）， and the difference was statistically significant （P <0.05）. There was statistical difference in lipid layer between the main squint group and the non-main squint group （P <0.05）. TMH and average hyperemia index of patients with constant exotropia were not correlated with strabismus angle， but negatively correlated with the first NIBUT and average NIBUT. Conclusion The ocular surface abnormality of children with constant exotropia before operation has nothing to do with the water layer， but is related to the change of lipid layer， and the greater the strabismus angle， the more unstable the tear film. Children withstrabismus， especially those with large strabismus angle， should be instructed to blink correctly and give priority to the use of artificial tears containing lipids.

[Key words] Constant exotropia; Tears; Ocular surface; Strabismus angle; Correlation

斜视是一种多发病，据统计斜视占儿童群体的1.3%[1]。由于眼位偏斜打破了角膜位于正中的正常状态，会导致眼表状态与正常状态不同[2]。临床工作中常遇到斜视病人 BUT 时间缩短，结膜充血等，并且斜视度大患者中主诉干涩者较多。既往研究多集中于斜视术后的眼表状况，斜视术前的眼表状态研究较少，为探究斜视度数是否与眼表状态相关，南方医科大学顺德医院（我院）应用眼表综合分析仪对斜视患儿进行了研究。

1资料与方法

1.1一般资料

回顾性分析我院眼科2019年4月至2021年5月诊断为恒定性外斜视的68例患者资料，共136眼。依据是……