目的：探讨斜视手术后患者的眼表情况。

方法：选取2015-05/2016-10我院住院治疗的斜视患者188例240眼，按手术切口不同分为3组：A组85例100眼行角膜缘切口； B组35例50眼行跨肌止端切口； C组68例90眼行近穹窿切口(包括Parks切口及改良的Parks切口)。行单条眼外肌手术者75眼，行2条眼外肌手术者110眼，行3条眼外肌手术者55眼。采用眼表综合分析仪分别于术前1d，术后1d，1、2、4wk检测非侵入性首次泪膜破裂时间(first noninvasive Keratograph tear breakup time，NIKBUTf)和泪河高度(tear meniscus height，TMH)并进行统计分析。

结果：与术前1d比较，各不同切口组术后1d TMH均明显增高，NIKBUTf均明显缩短，差异均有统计学意义(P<0.05)。A组术后2wk时NIKBUTf恢复至术前水平，B、C组术后1wk时恢复至术前水平。A、B组术后2wk时TMH恢复至术前水平，C组术后1wk时恢复至术前水平。单条肌肉眼外肌手术者术后1wk TMH和NIKBUTf恢复至术前1d水平，行2条和3条肌肉手术者术后2wk时各指标恢复至术前水平。

结论：手术切口选择和手术累及的肌肉条数都会影响斜视患者术后眼表健康情况； 选择近穹窿切口行斜视手术恢复较快； 斜视手术中所累积肌肉数越少，对眼表的影响越小。

METHODS: One hundred and eighty-eight hospitalized patients(240 eyes)with strabismus from May 2015 to October 2016 in Aier Hospital were divided into 3 groups according to the type of incision: 85 cases(100 eyes)with the corneal limbus incision in Group A; 35 cases(50 eyes)with the cross-muscle incision in Group B; 68 cases(90 eyes)with the adjacent-fornix incision(including Parks incisions and improved Parks incisions)in Group C. And 75 eyes with single extraoeular muscle surgery, 110 eyes with 2 extraoeular muscle surgery, 55 cases with 3 extraoeular muscle surgery. The first noninvasive tear film break-up time(NITBUTf)and the tear meniscus height(TMH)were tested by Oculus anterior segment analyzer preoperatively and 1d, 1, 2 and 4wk postoperatively. The data were studied by statistics.

RESULTS: Comparing with preoperative, TMH increased significantly at post-operatively 1d in all group, NIKBUTf reduced significantly(P<0.05). NIKBUTf was recovered in Group A at post-operative 2wk. NIKBUTf were recovered in Group B and C at post-operative 1wk. TMH were recovered in Group A and B at post-operative 2wk. TMH was recovered in Group C at post-operative 1wk. NIKBUTf and TMH were recovered with the single extraoeular muscle surgery at post-operative 1wk. They were recovered at post-operative 2wk with the 2 and 3 extraoeular muscle surgery.

CONCLUSION: Surgical incision and surgical muscle number may affect the ocular surface of the people after strabismus surgery. The adjacent fornix conjunctival incision has less effect. The less number of muscles in strabismus surgery, the less effect on ocular surface.