| ObjectiveTo study the influence of anti-glaucoma medications and phacotrabeculectomy on the ocular surface and insulin levels in the tear of glaucoma patients.Method1. Medication group:Twenty-seven patients (30eyes) with glaucoma combined with cataract (Tian Jin Medical University Eye Hospital) were enrolled in this group, with anti-glaucoma medications. The ocular surface score, Schirmer I test (SIT), film break-up time (BUT), corneal fluoresce in staining were evaluated. The content of insulin in the tear was quantified by radio immunoassay (RIA), as the object of medication group, the effect of anti-glaucoma medications on ocular surface and insulin in glaucoma tear.2. Operation group:Medicine group patients accepted phacotrabeculectomy, and observing the ocular surface score, Schirmer I test (SIT), film break-up time (BUT), corneal fluoresce in staining and collect tear lm,3m,6m post-operation, The content of insulin in the tear was quantified by radio immunoassay (RIA), as the object of operation group, the effect of anti-glaucoma medications and phacotrabeculectomy on ocular surface and insulin in glaucoma tear.3. Control group:thirty volunteers (30eyes) with no contact lens wearing history (Tian Jin Medical University Eye Hospital) were enrolled in this group. Observing the ocular surface score, Schirmer I test (SIT), film break-up time (BUT), corneal fluoresce in staining and collect tear, the content of insulin in the tear of all the volunteers was quantified by radio immunoassay (RIA).Result1. There were no statistical significant difference between the time, combination type of medications and ocular surface scores, respectively χ2=3.27, P>0.05;χ2=1.08, P>0.05. There were no statistical significant difference between the time, combination type of medications and dry eye, respectively χ2=0.74, P>0.05; χ2=3.992, P>0.05.2. There was statistical significant difference of the content of insulin in control group and medication group, t=-4.652, P=0.000<0.01. 3. There was statistically significant difference of without dry eye patients and with dry eye patients in control group and medication group, respectively t=7.590, P=0.000<0.01, t=2.728, P=0.000<0.01.4. The rank-sum test to observe the effect of operation on ocular surface, χ2=28.851, P <0.05, statistically significant difference. The incidence of dry eye in operation group were higher than those in control group, there was statistically significant difference between control group and1month,3month,6month post-operation by chi-square test, χ2=67.419, P<0.05; there was statistically significant difference between control group and3month,6month post-operation, control group and1month post-operation, control group and3month post-operation, control group and6month post-operation,1month and6month post-operation,3month and6month post-operation, respectively χ2=61.054, P<0.05; χ2=48.585, P<0.05;χ2=38.571, P<0.05; χ2=56.000, P<0.05; χ2=26.447, P<0.05; χ2=17.778, P<0.05; there was no statistically significant difference between1month and3month post-operation, χ2=1.964, P>0.05.5. A LSD-t test to compare control group and operation group of insulin content, there was statistically significant difference between control group and1month post-operation, control group and3month post-operation, control group and6month post-operation,1month and3month post-operation,1month and6month post-operation,3month and6month post-operation, respectively t=8.858, P=0.000<0.05; t=7.055, P=0.000<0.05; t=4.565, P=0.000<0.05; t=6.019, P=0.000<0.05; t=-11.133,P=0.000<0.05;t=-5.680,P=0.000<0.05.6. There was statistically significant difference of without dry eye patients and with dry eye patients in1month post-operation,3month post-operation,6month post-operation, respectively t=3.227, P=0.003<0.01; t=11.349, P=0.000<0.01t=5.671,P=0.000<0.01.7. The relationship between medication group, operation group and dry eye, the incidence1month post-operation was higher than that of medication group,3month,6month post-operation. There was statistically significant difference between medication group and1month,3month,6month post-operation by chi-square test, χ2=31.250, P<0.05; There was statistically significant difference between medication group and3month,6month post-operation, medication group and1month post-operation, the medication group and6month post-operation,1month and6month post-operation,3month and6month post-operation, respectively χ2=21.136, P<0.05; χ2=5.192, P<0.05;χ2=11.381, P<0.05;χ226.447, P<0.05; χ2=17.778, P<0.05, there was no statistically significant difference between the medication group and3month post-operation,1month and3month post-operation, respectively χ2=1.002, P>0.05; χ2=1.964, P>0.05.8. A LSD-t test to compare medication group and operation group of insulin content, there was statistically significant difference between medication group and1month post-operation, medication group and3month post-operation, medication group and6month post-operation, t=-4.785, P=0.000<0.05; t=-2.279, P=0.029<0.05; t=-0.794, P=0.432>0.05. The comparison of1month and3month,1month and6month,3month and6month post-operation compared with previous.9. The relationship of the content of insulin and the ocular surface score, make Spearman rank analysis:control group r=-0.663, P=0.000<0.01; medication group r=-0.528, P=0.003<0.01;1months post-operation r=-0.967, P=0.000<0.01;3month post-operation r=-0.969, P=0.000<0.01;6post-operation r=-0.903, P=0.000<0.01, showed a negative relationship between insulin levels and ocular surface score.Conclusion1. There is no difference of the medication time, combination types of topical anti-glaucoma medications on the ocular surface scores and dry eye, but the content of insulin of medication group was lower.2. Phacotrabeculectomy can affect the ocular surface, and dry eye was also increased post-operation, and the decline of the content of insulin in tear.3. The effect of phacotrabeculectomy and drugs was more apparent than that of anti-glaucoma medications, but there was no statistically significant difference between anti-glaucoma medications and6month post-operation.4. Dry eye patients with lower insulin than without dry eye patients.5. There was negative correlation between the content of insulin and the ocular surface score, with the decrease of insulin level in tear, eye symptoms and signs more obvious. |
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