不同切口白内障超声乳化及人工晶状体植入术后泪膜稳定性观察

目的探讨透明角膜切口与巩膜隧道切口白内障超声乳化及人工晶状体植入术后泪膜稳定性的差异。方法抽取拟行白内障超声乳化术的老年性白内障患者60例68眼,随机分为两组,A组30例32眼,予透明角膜切口施术,B组30例36眼,予巩膜隧道切口施术。检测两组术前1天,术后1、7、14、30天的泪膜破裂时间(BUT)、基础泪液分泌试验(Sit)、角膜荧光素染色积分(FL)以及患者主观干眼感觉症状。结果 A组术后第1天较术前BUT明显缩短,Sit、角膜荧光素染色积分明显增高(P<0.05或0.01);第7天时Sit,第30天时BUT、角膜荧光素染色积分恢复至术前水平(P>0.05)。B组术后第1天BUT明显缩短,Sit明显增高(P<0.05或0.01),角膜荧光染色积分比较差异无统计学意义(P>0.05);术后第7、14、30天,BUT、Sit逐渐恢复至术前水平(P>0.05)。两组主观干眼感觉症状,术后第1天均明显增高(P<0.05),14天后基本恢复到术前状况(P>0.05)。结论巩膜隧道切口泪膜的稳定性较透明角膜切口白内障摘除术显著降低,但主观感觉无明显差异。

Observation on the tear film stability after different incision phacoemulsification and intraocular lens implantation

Objective To study the tear film stability after cataract extraction and intraocular lens implantation with different incision positions.Methods 60 patients with 68 eyes scheduling for cataract extraction by phacoemulsification cataract surgery were randomly divided into two groups.Group A of 32 eyes of 30 patients were given the treatments to clear corneal incision,group B of 30 patients with 36 eyes were given the scleral tunnel incision surgery.Tear breakup time(BUT),basal tear secretion test(Sit),corneal fluorescein staining points(FL),and patients with subjective symptoms of dry eye feeling were test on a day preoperative,the 1st,7th,14th,30th day postoperative.Results The BUT of a day preoperative was shorter than that of the 1st day after operation in group A,the Sit and the FL was increased(P<0.05 or 0.01);Sit on the 7th day and BUT,corneal fluorescein staining points on the 30th day returned to preoperative level(P>0.05).The BUT of a day preoperative was shorter than that of the 1st day after operation in group B,the Sit increased(P<0.05 or 0.01),no significant difference was found in corneal staining points(P>0.05);the BUT,Sit gradually returned to the preoperative level on the 7th,14th,30th day after operation(P>0.05).the feeling of dry eye symptoms got worse on the 1st day after operation in both groups(P<0.05),but returning to the preoperative status on the 14th day after operation(P>0.05).Conclusion The tear film stability of the surgery by the sclera tunnel incision is less than surgery by clear corneal incision,but no different is found in the subject sensation of dry symptoms.