目的：使用共聚焦显微镜观察氟米龙滴眼液联合玻璃酸钠滴眼液对干燥综合征型干眼患者中央角膜前弹力层神经纤维的改善。方法： 采用前瞻性双盲随机对照临床研究。将2017-01/2020-07在我院诊断为干燥综合征型干眼患者52例104眼，随机分为试验组26例52眼使用0.1%氟米龙滴眼液联合0.3%玻璃酸钠滴眼液治疗，对照组26例52眼使用0.3%玻璃酸钠滴眼液治疗。记录两组患者治疗前和治疗2、4、12wk的中央角膜前弹力层神经纤维直径、串珠数和弯曲度评分以及泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)和眼压。结果： 治疗前两组患者中央角膜前弹力层神经纤维直径、串珠数和弯曲度评分、BUT、SⅠt和眼压比较均无差异(P>0.05)，治疗2、4和12wk后，试验组患者BUT均比对照组延长(P<0.05)，治疗12wk，试验组比对照组SⅠt增加、神经纤维直径增粗、串珠数减少、弯曲度评分降低(均P<0.05)，治疗12wk两组患者眼压无差异(P>0.05)。结论：氟米龙滴眼液联合玻璃酸钠滴眼液治疗干燥综合征型干眼患者安全有效，有助角膜神经恢复。

AIM: To observe the nerve morphological changes in cornea of fluorometholone eye drops combined with sodium hyaluronate eye drops in the treatment of dry eye of Sj&#xF6;gren's syndrome by in vivo confocal microscopy(IVCM).METHODS: From January 2017 to July 2020, totally 52 dry eye patients(104 eyes)of Sj&#xF6;gren's syndrome in our hospital were enrolled and were randomly divided into two groups: 26 patients(52 eyes)in the experimental group were treated with 0.1% fluorometholone eye drops and sodium hyaluronate eye drops, while 26 patients(52 eyes)in the control group were treated with sodium hyaluronate eye drops alone. The diameter of central corneal nerve fibers, the number of nerve beads, the score of nerve tortuosity, tear film break-up time(BUT), Schirmer I test(S I t)and non-contact intraocular pressure were measured before treatment and 2, 4 and 12wk after treatment.RESULTS: There were no significant differences in the results of the diameter of central corneal nerve fibers, the number of nerve beads, the score of nerve tortuosity, BUT, S I t and non-contact intraocular pressure between the two groups before treatment(P>0.05). At 2, 4 and 12wk after treatment, the BUT prolonged in the experimental group compared with the control group(P<0.05); At 12wk after treatment, the diameter of corneal nerve fibers increased, the number of nerve beads and the nerve tortuosity score decreased, the S I t increased in the experimental group compared with the control group(all P<0.05), and there were no significant difference in non-contact intraocular pressure(P>0.05).CONCLUSION: Fluorometholone eye drops combined with sodium hyaluronate eye drops is safe and effective in the treatment of Sj&#xF6;gren's syndrome related dry eye, and contribute to corneal nerve recovery.

广西壮族自治区卫生健康委员会自筹经费科研课题(No.Z20200920); 广西壮族自治区人民医院青年基金项目(No.QN2019-10)