超声乳化白内障吸除术后干眼相关症状对生存质量的影响及其评估方法

目的 探讨超声乳化白内障吸除术后干眼相关症状对生存质量的影响及其评估方法。方法 采用横断面研究方法，随机选取103例(103眼）行超声乳化白内障吸除联合人工晶体植入术患者作为研究对象，术后90 d测量患者视力、泪膜破裂时间、角膜荧光素染色积分、眼表疾病指数（OSDI），进行基础泪液分泌试验，分别采用时间均衡法（TTO）、标准博弈法（SG1, SG2）、等级尺度法（RS）测量效用值评估患者生存质量。结果 TTO、SG1、SG2和RS法测得的效用值分别为0.95±0.11、0.96±0.50、0.99±0.06和0.80±0.12，除TTO法与SG1法测得效用值差异无统计学意义，其余效用值间比较差异均有统计学意义（P<0.05）。OSDI和视力与四种方法测得的效用值均存在显著相关性，与RS法测得的效用值相关性最显著。无干眼相关症状者（OSDI≤12分）四种方法测得的效用值均高于有干眼相关症状者（OSDI >12分），其中RS法测得的两者的效用值差异有统计学意义（P<0.05）。结论 超声乳化白内障吸除术后的干眼相关症状影响患者的生存质量，RS法测量的效用值在评估该疾病对生存质量的影响时具有较强的敏感性。

Effect and evaluation of dry eye-related symptoms on quality of life after phacoemulsification for cataract

Objective To investigate the effect and evaluation of dry eye-related symptoms on quality of life after phacoemulsification for cataract. Methods Cross-sectional design was adopted, and 103 patients (103 eyes) undergoing phacoemulsification for cataract were randomly selected. Ninety days after operation, the visual acuity, tear film break up time, fluorescence integral and ocular surface disease index (OSDI) were measured, Schirmer I test was performed, and values of utility were determined with time trade-off (TTO), standard gamble (SG1, SG2), and rating scale (RS) to evaluate the quality of life. Results The values of utility determined by TTO, SG1, SG2, and RS were 0.95±0.11, 0.96±0.50, 0.99±0.06 and 0.80±0.12 respectively, and there were significant differences (P<0.05) among these values of utility except for the pair obtained by TTO and SG1. OSDI and visual acuity were significantly related to the four values of utility, especially that obtained by RS. The values of utility determined by TTO, SG1, SG2 and RS in patients without dry eye-related symptoms (OSDI≤12 points) were higher than those in patients with dry eye-related symptoms (OSDI>12 points), and there were significant differences in the values of utility obtained by RS between patients with dry eye-related symptoms and those without dry eye-related symptoms (P<0.05). Conclusion Dry eye-related symptoms after phacoemulsification for cataract have negative impact on quality of life, and the value of utility measured by RS is more sensitive in evaluating the effect of the disease on quality of life.