Effect Of NPTS Combined With Corneal Stromal Lenticule Implantation On Ocular Surface

Objective: To investigate the effect of non-penetrating trabecular surgery combined with corneal stromal lenticule implantation on the ocular surface of patients with primary open angle glaucoma.Methods: Eighty eyes of 61 patients with primary open angle glaucoma were enrolled and divided into two groups according to the surgical method.The observation group was NPTS combined with corneal stromal lenticule implantation,and the control group was trabeculectomy.There were 29 patients(40 eyes)in the observation group and 34 patients(40 eyes)in the control group.Two patients underwent NPTS combined with corneal lenticule implantation in one eye and trabeculectomy in the other eye.The ocular surface disease index score(OSDI),break-up time(BUT),schirmer Ⅰ test(SIT),meibomian gland loss score,Nelson grade of conjunctival impression cytology and goblet cell density were compared between the two groups 1 day before surgery and 1 week,1 month and 3 months after surgery.Results : OSDI score: in the observation group,there were statistically significant differences in 1 week and 1 month after surgery compared with those before surgery(P<0.05),but there was no statistically significant difference in 3 months after surgery compared with those before surgery(P>0.05).In the control group,the difference was statistically significant(P<0.05).At 1 week and 3 month after operation,the differences between the two groups were statistically significant(P<0.05).BUT: In the observation group,the difference was statistically significant(P<0.05).In the control group,there was significant difference between 1 week and 1 month after operation and before operation(P<0.05),but there was no significant difference between 3 months after operation and before operation(P>0.05).At1 week,1 month and 3 months after operation,the differences between the two groups were statistically significan(P<0.05).SIT: in the observation group,there were statistically significant differences between 1 week and 3 months after operation and before operation(P<0.05),but there was no statistically significant difference between 1 month after operation and before operation(P>0.05).In the control group,there were significant differences between 1week and 1 month after operation and before operation(P<0.05).There was no significant difference between the two groups at 1 week,1 month and 3 months after operation(P>0.05).Meibomian gland score: there was no significant difference between the observation group after operation and before operation(P>0.05).In the control group,the difference between 3 months after operation and before operation was statistically significant(P<0.05).There was no significant difference between the two groups at 1 week,1 month and 3 months after operation(P>0.05).Nelson grade:in the observation group,there were statistically significant differences between 1 week and 1 month after operation and before operation(P<0.05),but there was no statistically significant difference between 3 months after operation and before operation(P>0.05).In the control group,the differences were statistically significant(P<0.05).At 3 months after operation,the difference between the two groups was statistically significant(P<0.05).Goblet cell density:in the observation group,there were statistically significant differences between 1 week and 1month after operation and before operation(P<0.05),but there was no statistically significant difference between 3 months after operation and before operation(P>0.05).In the control group,the difference was statistically significant(P<0.05).At 1 week,1 month and 3 months after operation,the differences between the two groups were statistically significant(P<0.05).Conclusion: NPTS combined with corneal stromal lenticule implantation has less impact on the early ocular surface of patients with primary open angle glaucoma than trabeculectomy,and the postoperative ocular surface recovers faster.