The Clinical Effect Observation Of Using HIALID Eye Drop After Anti-glaucoma Surgery

Backgound: Recently, with the surgical instruments'continual improvement and microtechnique's development, anti-glaucoma surgery have been almost perfect.But with the anti-glaucoma operation's extensive carrying out ,and scholar's more study on ocular surface diseases ,discover that a lot of patients possesing dry eye symptom after operation, light or severe,and the symptom will make satisfaction decreasing.And the unfit symptom happens easily behind trabeculectomy. Investigation indicate that the symptom is relative to using anti-metabolism drug,bleb-filtration destroying eyeball's construction and tear film integrity decreasing postoperative.At present scholars'research about dry eye symptom behind ocular surgery surround to phacoemulsification and refractive surgery generally.The investigation of dry eye after anti-glaucoma is fewer. Now investigation manifest that trabeculectomy and iridectomy can influence tear film by following some aspects :1,bleb-filtration interacts eyelid blinking,and then affects tear film distribution near bleb-filtration,so causing regional cornea drying,epitheliumdefecting ,cornea dell forming,and patients appear dry eye eventually.2,Because nonfunctioning bleb-filtration and using anti-metabolism drug , bulbar conjunctiva epithelium construction altering and aqueous fluid infiltrating to conjunctival sac which lead to dry eye symptom.3,Operative incision of iridectomy is near to limbus of cornea .Though the incision is little,it could interfere the function of stem cell near incision or normal function of cornea epithelium cell, making mucin layer of tear film damaged,and furthermore result in tear film disruption or not forming.At the same time ,the operative incision produces denervated govern of upper half cornea , resulting in cornea sensation decreasing,"tear feedback system"is disturbed and tear secretion decreases accordingly.4,Due to the using of polydocanol in surgery ,resulting in cornea epithelium denudation,cornea edema;postoperative incision healing and mechanical damage of microvilli and fine relief,which can result in ocular surface anomalism,tear film stability decreasing .At present the research about effection of anti-glaucoma to ocular surface tear film is less. It is meaningful that investing the rule of anti-glaucoma surgery to tear film postoperative,further approachingthe development mechanism of dry eye and preservation program .Objective:To observe the clinical effect of using HIALID eye drop after anti-glaucoma operation.Methods:In the experiment choosing 60 patients(114 eyes) with glaucoma,further divided A group and B group according to operation method,A group were randomly divided A1 group(30eyes) and A2 group (30 eyes) .A1 group were given PaLiBai eye drop 4/d two weeks after trabulectomy,A2 group were given palibai eye drop 4/d two weeks and HIALID eye drop 4/d four weeks after surgery. B group were randomly divided B1 group(27eyes) and B2 group (27 eyes) .B1 group were treated with PaLiBai eye drop 4/d two weeks postoperative ,B2 group were treated with palibai eye drop 4/d two weeks and HIALID eye drop 4/d four weeks postoperative. Respectively examined and recorded the patients'subjective symptom,Schirmer-I test (no anesthesia),tear break-up time(BUT) and cornea fluorescein staining one day preoperative,a week,two weeks,four weeks postoperative. Compare the examination consequence of A1 group with A2 group,B1 group with B2 group,and preoperation with postoperation respectively.Results:Preoperative the consequence of A1 group and A2 group is no significant difference(P>0.05). Postoperative the score of corneal fluorescein of A1 group was higher than preoperative, BUT shorted than preoperative (P<0.05), score of A2 group were reduced and BUT was shorter than A1 group a week,two weeks,four weeks postoperative (P<0.05).ST was no different (P>0.05), the incidence of subjective symptom of A2 group is lower than A1 group (P<0.05).Preoperative the consequence of B1 group and B2 group is no significant difference (P>0.05)。Postoperative the score of corneal fluorescein of B1 group was higher than preoperative, BUT shorted than preoperative(P < 0.05).But the score of corneal fluorescein of B1 group four weeks postoperative was no different with preoperative(P>0.05).Postoperative ST of B2 group and B1 group were shorter than preoperative.Postoperative BUT of B2 group prolonged than B1 group ,the score of corneal fluorescein staining of B2 group were reduced than B1 group (P<0.05). The subjective symptom of two groups were no different Postoperative (P>0.05).Conclusion: 1,Due to the physiological eyeball constructionand ocular surface integrity were damaged after anti-glaucoma,the patients were aware of conjunctiva hyperemia,foreign body sensation and so on ,the examination related to tear function occurred abnormal alteration.2,By using HIALID 0.1 eye drop in A2 group and B2 group the subjective symptom of patients was lightened,the tear film stability elevated.3,Application of artificial tears (no preservative or little preservative) after ophthalmologic operation would relief dry eye symptom,further raise satisfaction of surgery.