目的：观察 1 g/L 玻璃酸钠滴眼液（不含防腐剂）对圆锥角膜患者配戴硬性透气性角膜接触镜（rigid gas permeable，RGP）相关性干眼的疗效。方法：选择 2016 年 1 月至 2017 年 5 月来沈阳何氏眼科医院门诊就诊的 90 例透气性角膜接触镜相关性干眼圆锥角膜患者，随机分为 3 组，每组 30 例（60 眼）：A 组使用 1 g/L 玻璃酸钠滴眼液（不含防腐剂），4 次/d，1 滴/次；B 组使用舒润液（博视顿），4 次/d，1 滴/次；C 组在使用舒润液（博视顿）（4 次/d，1 滴/次）后 10 min 再用 1 g/L 玻璃酸钠滴眼液（不含防腐剂）（4 次/d，1 滴/次）。观察各组用药前 1 d 与用药后第 1、2、4 周的眼部症状评分、Schirmer I 试验（Schirmer I test，SIT）、泪膜破裂时间（break-up time，BUT）、角膜荧光染色评分变化。结果：3 组在用药 1 周时的干眼症状、BUT 和角膜荧光染色均较治疗前有明显改善（P < 0.05），3 组 SIT 值治疗前后差异均无统计学意义（P > 0.05）。各组各项指标在治疗第 1、2、4 周时差异无统计学意义（P > 0.05）。A 组与 B 组对干眼症状、SIT 和 BUT 的改善作用差异无统计学意义（P > 0.05）；A 组较 B 组在改善角膜荧光染色的作用上更明显，差异有统计学意义（P < 0.05）。C 组对改善干眼症状上优于 A 组（P < 0.05）。C 组对改善干眼症状和角膜荧光染色作用优于 B 组（P < 0.05）。结论：1 g/L 玻璃酸钠滴眼液（不含防腐剂）能够稳定泪膜，促进角膜上皮损伤修复，改善圆锥角膜患者配戴 RGP 所致干眼症状，具有一定的临床应用价值。

Objective: To investigate the clinical efficacy of sodium hyaluronate eye drops in the treatment of dry eye in keratoconus patients wearing rigid gas permeable (RGP) contact lens. Methods: Ninety keratoconus cases of dry eye related to wearing RGP contact lens from January 2016 to May 2017 were enrolled and divided into 3 groups randomly, including 30 cases (60 eyes) in each group. In group A, preservative-free sodium hyaluronate eye drops (EUSAN GmbH, German, specifications: 10 mL) were administered, 1 drop each time, 4 times daily; In group B, rewetting drops (BOSTON), 1 drop each time, 4 times daily; In group C, rewetting drops were initially given, followed by sodium hyaluronate eye drops 15 min later. All patients were evaluated by subjective symptoms of dry eye, Schirmer I test (SIT), break-up time (BUT) and corneal fluorescent staining, at pre-therapy and 1, 2, 4 weeks after treatment. Results: The subjective symptoms of dry eye, BUT and corneal fluorescent staining of three groups were significantly improved at 1 week after therapy than the data before therapy (all P < 0.05), SIT of three groups did not significantly differ before and after therapy (P > 0.05). Each index when measured after 1, 2 and 4 weeks had no significant difference in each group (all P > 0.05). There was no significant difference in subjective symptoms, SIT and BUT between group A and group B (all P > 0.05), whereas corneal fluorescent staining in group A was superior to group B (P < 0.05). The subjective symptoms of dry eye were significantly better than those in group A (P < 0.05). The subjective symptoms of dry eye and corneal fluorescent staining in group C were significantly better than those in group B (both P < 0.05). Conclusion: Administration of sodium hyaluronate eye drops (preservative-free) at a dose of 1 g/L can stabilize the tear film, promote the repair of corneal epithelial defects and significantly improve dry eye symptoms and signs in keratoconus patients wearing RGP contact lens, which has application value in clinical practice.

目的：通过球结膜下注射基质金属蛋白酶(metalloproteinase,MMP)-1、3构建结膜松弛症的动物模型。方法：20只新西兰大白兔随机分为4组：对照组无干预措施；伪造模组球结膜下注射生理盐水；MMP-1组球结膜下注射MMP-1；MMP-3组球结膜下注射MMP-3。8周后观察眼前节照相和眼前节光学相干检查、泪液蕨类试验及结膜组织光镜检查结果。结果：对照组和伪造模组未见结膜皱褶形成，泪液羊齿状结晶样结构完整，光镜下未见胶原和弹力纤维破坏；MMP-1组可见结膜皱褶形成，泪液羊齿状结晶样结构破坏，光镜下见胶原和弹力纤维破坏；MMP-3组未见结膜皱褶形成，泪液羊齿状结晶样结构部分破坏，光镜下见胶原和弹力纤维部分破坏。结论：球结膜下注射MMP-1可构建结膜松弛症1~2级的动物模型。

Objective:To establish an animal model of conjunctivochalasis by subconjunctival injection of matrix metalloproteinase 1 and 3. Methods:New Zealand white rabbits were randomly divided into four groups, the control group had no intervention measures; Pseudo model group was injected susbconjunctival with normal saline; MMP-1 group was injected subconjunctival with matrix metalloproteinase 1; MMP-3 group was injected subconjunctival with matrix metalloproteinase 3. Afer 8 weeks, the results of anterior segment photography and optical coherence test, tear fern test and conjunctival tissue light microscopy were observed. Results:No conjunctival folds were observed in the control group and Pseudo model group, the lacrimal fern-shaped crystalline structures were intact, and no destruction of collagen and elastic fbers was found under the light microscope. In MMP-1 group, conjunctival folds were formed, lacrimal ferns crystalline structures were damaged, and collagen and elastic fbers were damaged under light microscope. No conjunctival folds were found in MMP-3 group, and the lacrimal ferns crystalline structure was partially destroyed, while the collagen and elastic fibers were partially destroyed under light microscope. Conclusion:Subconjunctival injection of matrix metalloproteinase-1 can construct the animal model of conjunctivochalasis of 1-2 grades.