高龄白内障患者晶状体超声乳化术后泪膜变化及干眼症的发生

目的了解高龄白内障晶状体超声乳化术后泪膜的变化情况。方法选择高龄（〉80岁）晶状体超声乳化手术23例（28眼）作为高龄组,另随机抽取老年性白内障30例（39眼）作为对照组。分别于术前、术后1、7、30、90及120d进行症状、角膜荧光素染色（FL）、泪膜破裂时间（BUT）、基础泪液分泌试验（SIt）调查。结果与术前相比,两组术后120d内主诉眼部不适症状者明显增多;两组术后1周内FL增多,1月内BUT及SIt明显缩短,与术前比较差异有统计学意义（P〈0.05）;高龄老年组BUT和FL的恢复较对照组时间长（P〈0.05）,两组间SIt的恢复程度差异无统计学意义（P〉0.05）。结论晶状体超声乳化手术在一段时间内可影响泪膜的稳定性,高龄患者的术后恢复时间较长,应注意术前对泪膜功能的检测和术中术后对泪膜的保护。

Changes of tear film and the occurrence of dry eye syndrome following phacoemulsification in highly senile patients with age-related cataract

Objective To study the changes of tear film following cataract operations in highly senile patients. Methods 28 eyes of the senile group （23 senile age-related cataract patients over 80 years old） had undergone cataract surgeries. 39 eyes （30 senile patients with age-related cataract） served as the control group. The subjective complaints of dry eye, fluorescence integral （FL）, break-up time （BUT） and Schinmer Ⅱtest （Sit） were determined before and after cararact operations at different times （ preperation and post-operation 1 d, 1 week, 1 month, 3 months and 4 months）. Results Subjective complaints of dry eye within 3 months after the operations were significantly increased compared with those before the operations. The mean scores of FL was greatly increased within 1 week. 1 month after the operations, the mean break up time and the schinmer Ⅰ test in the senile group was greatly decreased （ P 〈 0.05 ）. BUT and Sit were more significantly decreased in the senile group than in the control group. The serdie group needed more time to recover after the operations. Conclusion Cataract surgeries have effect on the tear film especially for senile age-related patients. The tear film function shoud be examined before operation, and shoud be protected.