年龄相关性白内障术后泪膜稳定性变化早期临床研究  

Early clinical research on tear film stability changes after surgery for age-related cataract

作　　者：李颖[1] 王从毅[1] 吴利安[2] 倪伟[1] 张林[2] 杨新光[1] 

机构地区：[1]中国陕西省西安市第四医院眼科,710004 [2]西安交通大学第一医院眼科,中国陕西省西安市710061

出　　处：《国际眼科杂志》2005年第4期677-680,共4页International Eye Science

基　　金：中国陕西省卫生厅科研基金资助项目(No.04D17)

摘　　要：目的:评价白内障术后不同时间泪膜稳定性的变化,探讨泪膜稳定性的变化与手术方式之间的关系。方法:设计自身配对研究。选择2003/2004期间在我院住院的年龄相关性白内障患者(随机检查110例120眼)。透明角膜切口超声乳化白内障及折叠式后房型人工晶状体植入组:80例(90眼);白内障囊外摘除联合后房型人工晶状体植入组:30例(30眼)。所有患者分别于术前、术后1,7d;1,3mo依次行SIt、BUT、角结膜荧光素染色并对其泪膜稳定性的变化进行分析。结果:术前两组SIt、B U T测定及角膜荧光染色无明显差异(P>0.05);与术前相比,两组术后1-2d,B U T测定明显缩短(P<0.001),差异有显著意义,其中囊外组较超声乳化B U T下降明显(P<0.05),SIt明显增加(P<0.001),差异有显著意义;两组增加的程度无显著意义(P>0.05);术后7d,两组SIt测定恢复到术前水平,差异无显著意义;两组恢复程度亦无明显差异SIt(P>0.05);术后1moBUT测定基本恢复到术前水平,差异无显著意义;两组恢复的程度亦无显著意义(P>0.05)。术后1d超声乳化组角膜荧光素染色为(+),伤口处角膜水肿,囊外组角膜荧光素染色为(+～++)。术后1mo,角结膜荧光素染色及伤口处角膜水肿基本恢复到术前水平。结论:年龄相关性白内障两种手术方式均影响泪膜稳定性,手术切口越大,影响泪膜稳定性越明显;但两种手术方式术后泪膜稳定性恢复程度却无显著性差异。AIM： To evaluate the tear film stability with different surgery methods and find out the relation between tear film stability changes and different surgical methods. METHORDS： This randomized study involved two groups.80 cases （Group Ⅰ） underwent phacoemulsification through clear corneal combined with foldable intraocular lens （IOL） implantation, and 30 cases （Group Ⅱ） underwent extracapsular cataract extraction combined with IOL implantation. Shirmer Ⅰ test （SIt）, breakup time （BUT）, and corneal fluorescein stain were measured preoperatively and i day and 7, 30, 90d postoperatively. RESULTS： The difference of SIt, BUT, and corneal fluorescein stain between the two groups preoperatively are not significant （P〉0.05）. At 2d and 2d postoperatively, the BUT in the two groups reduced greatly （P〈0.001）, and the BUT in group II was much less （P〈0.05）. SIt value in the two groups increased greatly （P〈0.001）, and the difference between the two groups was not significant （P 〉0.05）.At 30d postoperatively BUT recovered, and the difference between the two groups was not significant （P〉0.05）. At ld postoperatively, corneal fluorescien stain showed positive （＋） in Group Ⅰ and （＋＋） in Group Ⅱ, and there was corneal edema in the incision. At 30d postoperatively, corneal stain and edema recovered. CONCLUSION：Cataract surgery alters tear film stability. Larger surgical incision exists, and worse tear film stability occurs. However there is no significan difference for tear film stability recurrence between the two groups.

关 键 词：年龄相关性白内障 术后 泪膜稳定性 角膜荧光素 手术切口 手术治疗 

分 类 号：R779.66[医药卫生—眼科]