糖尿病患者超声乳化白内障术对泪膜的影响  

The early changes of tear film after phacoemulsification in diabetics

作　　者：马晓华[1] 李镜海[1] 毕宏生[2] 陈树悦[2] 

机构地区：[1]山东大学齐鲁医院眼科,济南250012 [2]济南施尔明眼科医院

出　　处：《中国实用眼科杂志》2005年第7期722-725,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨糖尿病对行超声乳化白内障吸除术患者泪膜的影响。方法选择行小切口超声乳化白内障吸除术的42例(60只眼)糖尿病白内障患者(试验组)及30例(42只眼)老年性白内障患者(对照组),观察分析两组术前,术后1天、1周、1个月、3个月的主观感觉,荧光素试验,泪膜破裂时间(breakinguptime,BUT),基础泪液分泌试验(Schirmertest,SIt)及干眼仪检查情况。结果术前两组相比,试验组BUT较对照组明显短,角膜荧光素着色点较对照组明显多,差异有显著意义(P<0.05);干燥异物感、SIt及干眼仪检查等级两组差异无显著意义(P>0.05)。与术前相比,试验组术后1天、1周、1月干燥异物感加重,术眼BUT明显缩短,差异有显著意义(P<0.05)。术后3个月接近术前水平,差异无显著意义(P>0.05)。对照组术后1天、1周干燥异物感加重,术眼BUT明显缩短,差异有显著意义(P<0.05)。术后1个月、3个月接近术前水平,差异无显著意义(P>0.05)。两组术后1天、1周角膜荧光素着色点及干眼仪检查等级均明显增高,差异有显著意义(P<0.05)。术后1个月、3个月接近术前水平,差异无显著意义(P>0.05)。术后1天泪液分泌量均明显增多,差异有显著意义(P<0.05)。术后1周、1个月、3个月接近术前水平,差异无显著意义(P>0.05)。术后1个月时,角膜荧光素染色>2分、BUT<5s的发生率随糖尿病病程的延长而增高,差异有显著意义(P<0.05)。糖尿病病程≥10年的患者中,BUT<5s的发生率女性高于男性,差异有显著意义(P<0.05)。BUT与年龄呈轻度负相关(r=-0.41,P<0.05)。结论糖尿病患者泪膜功能较差,是干眼症的易患人群,在行超声乳化白内障吸除术后其泪膜稳定性下降且恢复较慢,以老年、女性、糖尿病病程长者为甚。Objective To study the changes of tear film after phacoemulsification in diabetics. Methods 42 cases(60 eyes,test group) with diabetic cataract and 30 cases(42 eyes,control group)with age-related cataract who underwent phacoemulsification were chose and analysed the subjective complains of dry eye,tear break-up time,corneal fluorescein staining,tear film pattern by DR-1 tear interfermetry and Schirmer I test(SIt) value preoperatively and 1 day,1 week,1 month and 3 months postoperatively. Results Compared with the two groups preoperatively,the test group′s mean tear break-up time was less and the corneal fluorescein staining scores was more than that of control group( P <0.05).There was no significantly difference between the two groups′ subjective complains of dry eye,mean SIt value,grades of tear film pattern( P >0.05).Compared with the preoperation′s,the test group′s subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day,1 week and 1 month postoperatively( P <0.05).They all recovered their preoperative values at 3 months postoperatively( P >0.05).The control group′s subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day,1 week postoperatively( P <0.05).They all recovered their preoperative values at 1 month and 3 months postoperatively( P >0.05).The two groups′ corneal fluorescein staining scores and grades of tear film pattern increased significantly at 1 day and 1 week postoperatively( P <0.05).They all returned to their preoperative values at 1 month and 3 months postoperatively( P >0.05).The two groups′ mean SIt value increased significantly at 1 day postoperatively( P <0.05).It returned to its preoperative values at 1 week,1 month and 3 months postoperatively( P >0.05).At 1 month postoperatively,the longer the diabetes suffered,the higher the incidence of the corneal fluorescein staining >2 scores and BUT <5 seconds happened ( P <0.05).Among the diabetic history ≥10 years,the female′ incidence of BUT <

关 键 词：糖尿病患者 超声乳化白内障术 超声乳化白内障吸除术 老年性白内障患者 基础泪液分泌试验 糖尿病病程 角膜荧光素染色 干眼仪检查 泪膜破裂时间 荧光素试验 泪液分泌量 泪膜稳定性 对照组 BUT 异物感 方法选择 主观感觉 

分 类 号：R587.1[医药卫生—内分泌] R776.1[医药卫生—内科学]