白内障超声乳化联合人工晶状体植入手术后干眼发生的相关因素分析

目的评估不同危险因素在白内障超声乳化联合人工晶状体植入术后干眼发生中的作用,为术后干眼发生的预测及防治提供依据。方法记录93例(98只眼)术前无干眼白内障患者手术前及术后3个月常见的全身疾病,并进行干眼问卷调查及相关眼部检查,包括睑板腺功能检查、BUT、SchirmerⅠ试验、角膜荧光素染色等,对检查结果进行多因素回归分析及多元线性回归分析,分析其危险因素。结果 44例47只眼(48%)白内障术后确诊为干眼,Logistic回归分析显示:睑脂粘度(OR=2.670,P=0.025)和结膜松弛(OR=4.537,P=0.004)是白内障术后干眼发生的独立危险因素。糖尿病(OR=3.778,P=0.037)、高血脂(OR=11.645,P=0.023)、睑板腺分泌物(OR=5.660,P=0.025)及睑脂粘度(OR=2.881,P=0.018)是BUT值缩短的独立危险因素。多元线性回归分析显示:睑脂粘度与角膜染色呈正相关(F=79.282,P<0.001)。结论白内障术后干眼的发生与全身及局部多种因素相关,术前针对相关危险因素进行评估,可有助于术后干眼发生的预测并提前进行综合干预治疗。

Factors associated with dry eye after phacoemulsification and IOL implantation

Objective By evaluating the role of different risk factors in the occurrence of dry eye after phacoemulsification and IOL implantation,we expect to give a guidance for the prediction and treatment of dry eye after surgery. Methods 93 cataract patients (n=98 eyes) who had not had dry eye symptoms before surgery werer ecruited.3 months after surgery,dry eye questionnaire and related ocular examinations,including Meibomian gland function test,break-up time of tear film (BUT),SchirmerⅠtest,and cornea fluorescein staining (CFS),were performed. Multivariate regression and multiple linear regression analysis were conducted. Results 44 (47 eyes;48%) cataract patients were diagnosed as dry eye after surgery. Logistic regression analysis showed that the secretion character of Meibomian gland (OR=2. 670,P=0. 025)and conjunctival relaxation (OR=4. 537,P =0. 004)are independent risk factors for dry eye. Diabetes (OR=3. 778,P =0. 037),hyperlipidemia (OR=11. 645,P =0. 023),secretion of Meibomian gland (OR=5. 660,P =0. 025)and its character (OR=2. 881,P =0. 018) are independent risk factors for shortened BUT. Multiple linear regression analysis showed that the secretion character of Meibomian gland is positively correlated with corneal staining (F =79.282,P<0.001).Conclusions The occurrence of dry eye is associated with a variety of systemic and local factorsafter surgery in cataract patients. Evaluating related risk factors before surgery can help to predict the occurrence of postoper-ative dry eye and give comprehensive treatments in advance.