国际眼科纵览 ›› 2021, Vol. 45 ›› Issue (2): 135-140.doi: 10.3760/cma.j.issn.1673-5803.2021.02.009

• 综述 • 上一篇    下一篇

基于泪液功能单位的干眼治疗

张蕾   

  1. 天津市眼科医院 天津市眼科学与视觉科学重点实验室 南开大学附属眼科医院 天津医科大学眼科临床学院 天津市眼科研究所 300000
  • 收稿日期:2020-06-20 出版日期:2021-04-22 发布日期:2021-04-28
  • 通讯作者: 张蕾,Email:380502025@qq.com
  • 基金资助:
    天津市眼科医院科技基金面上项目(YKYB2001)  

Dry eye treatment based on tear functional units

Zhang Lei   

  1. Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin Eye Institute, Tianjin 300000, China
  • Received:2020-06-20 Online:2021-04-22 Published:2021-04-28
  • Contact: Zhang Lei, Email: 380502025@qq.com
  • Supported by:
    Science and Technology Fund of Tianjin Eye Hospital (YKYB2001)  

摘要: 干眼发病原因多,其主要特征是泪膜稳态失衡。泪膜稳态的维持得益于泪液功能单位各组成部分的正常运转。泪液功能单位由角膜、结膜、泪腺、睑板腺、泪腺以及连接它们的神经网络组成,通过调节方式控制泪液分泌。一个或多个组成部分功能失常会直接影响泪膜稳态而导致干眼。针对角膜的干眼治疗包括自体血清、神经生长因子、接触镜及抗炎治疗;针对结膜的干眼治疗包括维生素A、抗炎治疗、手术;针对泪腺的干眼治疗包括环孢素A、雄激素、泪腺原位再生;针对睑板腺的干眼治疗包括按摩热敷、ω-3脂肪酸的饮食补充;针对泪膜的干眼治疗包括补充泪液、刺激泪液分泌、减少泪液蒸发和减少泪液排出。了解泪液功能单位的各组成部分的生理功能及病理变化有助于干眼症的个性化治疗。(国际眼科纵览,2021, 45:135-140)


关键词: 干眼;眼表;泪膜稳态;泪液功能单位 ,   

Abstract: There are many causes of dry eye, and its main feature is the imbalance of tear film homeostasis. With the increase in knowledge regarding the pathophysiology of dry eye, it is found that the maintenance of tear film homeostasis benefits from the normal operation of each component of lacrimal function unit. Lacrimal functional unit comprises cornea, conjunctiva, lacrimal gland, meibomian glands and the neural network that connects them. It controls secretion of the tear film in a regulated fashion. Compromise in one or more components can result in homeostasis disruption of ocular surface leading to dry eye disease. Therapy targeting cornea includes autologous serum, nerve growth factor, contact lens and anti-inflammatory treatment; therapy targeting conjunctiva includes vitamin A, anti-inflammatory treatment and operation. Therapy targeting lacrimal gland includes cyclosporine A, androgen and regeneration of lacrimal gland; therapy targeting meibomian glands includes warm compresses, manual lid massage and ω -3 fatty acid. Therapy targeting tear film includes compensation of tear, stimulating tear production, controlling tear evaporation and regulating excessive nasolacrimal drainage. Understanding the physiological function and pathological changes of the main components of lacrimal function unit is helpful to provide ideas for personalized treatment of dry eye. (Int Rev Ophthalmol, 2021, 45: 135-140)


Key words: dry eye, ocular surface, lacrimal film homeostasis, tear film homeostasis