白内障超声乳化摘除手术对睑板腺功能的影响

目的 评估白内障超声乳化摘除手术对睑板腺功能的影响.方法 对拟接受白内障超声乳化摘除术的58例(58眼)于术前、术后1个月、术后3个月分别完成OSDI、睑缘形态评分、泪膜破裂时间、角膜上皮荧光素染色、泪河检查、睑板腺脂质分泌、泪液分泌功能等检查.结果 相比术前,术后患眼的OSDI评分明显上升,睑缘形态明显变差.相比术前,睑板腺脂质分泌在术后1个月时无变化,而3个月时明显变差.术后BUT一直在下降.但是,角膜上皮点状染色、泪液分泌功能以及泪河术后未见明显改变.结论 白内障手术可以诱发或加重睑板腺功能障碍.

Evaluation of meibomian gland dysfunction after phacoemulsification surgery

Objective To evaluate meibomian gland dysfunction after phacoemulsification surgery. Methods Fifty-eight eyes of 58 patients underwent phacoemulsification and were evaluated the OSDI, lid margin abnormalities, superficial punctate keratopathies (SPK), tear film break-up time (BUT), Schirmer test, lower tear meniscus height, depth, and area using anterior segment optical coherence tomography, and meibum expressibility pre-operatively and at 1 month and 3 months post-operatively. Results The OSDI were worse at 1 month and 3 months post-operatively (10.7±7.9, 25.7±7.9, 27.9±12.1, P<0.05 and P<0.05, respectively). Lid margin abnormalities were significantly increased (1.6±1.0, 2.0±1.2, 2.5±0.9, P<0.05 and P<0.05, respectively) and BUT decreased post-operatively (6.6±3.1, 4.3±1.9, 4.1±2.2, P<0.05 and P<0.05, respectively). Meibum expressibility decreased at 3 months post-operatively (1.8±0.9 vs 2.2±0.7, P<0.05); however, SPK, lower tear meniscus height, depth and area and the Schirmer test did not significantly change post-operatively (P>0.05). Conclusion Meibomian gland function may be altered without accompanying structural changes after phacoemulsification surgery.