刘洋
LIU Yang

• 1:自贡市第四人民医院眼科

摘要(Abstract)：

目的:探讨不同尺寸角膜切口对白内障超声乳化术后患者泪膜及泪液功能的影响。方法:64例白内障患者,均分为对照组和实验组,对照组行3.0 mm透明角膜切口白内障超声乳化术,实验组行1.8 mm透明角膜切口白内障超声乳化术;于手术前、术后1周、1个月及3个月时比较2组患者干眼频率、强度及加重情况评分,比较两组患者泪膜破裂时间(t BUT)、泪液分泌量(SⅠt)、上泪新月面积(UTMA)、下泪新月面积(LTMA)及总泪新月面积(TTMA)。结果:术前2组患者干眼频率、强度及加重情况评分,t BUT、SⅠt、UTMA、LTMA及TTMA比较,差异无统计学意义(P>0.05);术后2组患者干眼频率、强度及加重情况评分均较术前呈先升高后降低趋势,仅术后1周及1个月时显著高于术前(P<0.05或P<0.01),实验组术后1周时患者的干眼频率、强度评分显著低于对照组(P<0.05或P<0.01);术后1周及1个月时,2组t BUT及SⅠt均明显低于术前(P<0.05或P<0.01),且实验组术后1周时的t BUT及SⅠt均明显高于对照组(P<0.05或P<0.01);对照组患者术后1周时及1个月时的LTMA、TTMA,实验组术后1周时的LTMA及TTMA均显著低于术前(P<0.05或P<0.01)。结论:不同尺寸切口的白内障超声乳化术后早期均会导致不同程度的干眼症状,小切口手术对术后早期泪液功能相关指标影响较小。
Objective: To investigate the effect of different sizes of corneal incisions on tear film and tear function of patients with cataract after phacoemulsification. Methods: 64 patients with cataract after phacoemulsification were selected and randomly divided into the control group( n = 32) and the experimental group( n = 32). The control group underwent 3 mm clear corneal incision phacoemulsification,while the experimental group underwent 1. 8 mm clear corneal incision phacoemulsification. The Dry Eye Subjective Symptom Score( DES),Tear Film Break-up Time( t BUT) and Schirmer Ⅰ test( SIt) were compared between 2 groups before and after surgery. The tear Meniscus Area( TMA) was quantitatively detected by Optical Coherence Tomography( OCT). Results: The frequency,intensity and dry eye exacerbation scores increased at first and decreased later,and the above scores of 2 groups1 week and 1 month after surgery were significantly higher than those before surgery. The frequency and intensity scores of the experimental group 1 week after surgery were significantly lower than those of the control group( P < 0. 05 or P < 0. 01). The t BUT and SIt of 2 groups all decreased at first and then increased after surgery. The t BUT and SIt in 2 groups 1 week and 1 month after surgery were significantly lower than those before surgery,and the t BUT and SIt of the experimental group 1 week after surgery were significantly higher than those of control group( P < 0. 05 or P < 0. 01). The Upper/Lower Tears Meniscus Area,( LTMA/UTMA) and Total Tears Meniscus Area( TTMA) of 2 groups after surgery decreased at first and then increased,and LTMA,UTMA and TTMA 1 month after surgery of the experimental group were significantly higher than those of the control group( P < 0. 05 or P <0. 01). Conclusion: Different sizes of corneal incision after phacoemulsification can cause different degrees of dry eye symptoms in early stage,but small incision surgery has less influence on tear function related indexes at early stage after surgery.

关键词(KeyWords)： 角膜;干眼综合征;白内障超声乳化术;泪膜;泪液功能;泪膜破裂时间;泪液分泌量
cornea;dry eye symptoms;cataract phacoemulsification;tear film;tear function;tear film break up time;tear secretion

Abstract:

Keywords:

基金项目(Foundation): 四川省德阳市科委项目(2014SZ040)

作者(Author): 刘洋
LIU Yang

DOI: 10.19367/j.cnki.1000-2707.2018.07.020

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