糖尿病患者白内障吸除术致泪膜变化的相关因素研究  

Tear Film Changes after Phacoemulsification

作　　者：刘曦[1] 楼定华[1] 许叶圣[1] 

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003

出　　处：《浙江预防医学》2007年第9期8-10,共3页Zhejiang Journal of Preventive Medicine

摘　　要：目的观察糖尿病患者超声乳化白内障吸除术后对泪膜的影响因素。方法随机选取老年性白内障糖尿病患者25例(28眼)行超声乳化白内障吸除术,以20例单纯老年性白内障作为对照组,分别于术前、术后1d、3d、7d、30d、90d行主观感觉、泪膜破裂时间(breakup time BUT)、基础泪液分泌试验(Schirmer I test,SIt)、角膜荧光素染色检查。结果对照组超声乳化白内障吸除术前、术后1d、3d、7d干燥、异物感加重、比较BUT明显缩短(t=21.506,19.451,14.185),SIt分泌增多(t=-13.739,-16.139,-6.189),角膜荧光素染色率明显增高,差异均有统计学意义(P<0.01)。糖尿病组术前、术后1d、3d、7d、30d干燥、异物感加重,1d、3d、7d比较BUT、SIt具有统计学差异(t=6.922,5.550,4.832)SIt(t=-17.902,-13.146,-8.135),角膜荧光素染色率也有统计学差异(P<0.05),二组间术后30d、90d BUT及SIt逐渐恢复至术前水平。术后对照组15%BUT未能达到术前水平,糖尿病组38.09%BUT较术前更不稳定。在术后各随访中,对照组与糖尿病人组BUT术前、术后30d、90d有统计学差异(P<0.001),而SIt术前、术后二组间也有差异,荧光素角膜染色率糖尿病明显高于正常组,二组间经x2检验,差异有统计学意义。结论糖尿病患者超声乳化白内障吸除术后可致泪膜稳定性下降,使部分患者泪膜比术前更不稳定。因此建议术后可局部常规滴用人工泪液等眼液,促进泪膜功能恢复,尤其对糖尿病患者更为重要。Objective To evaluate tear film changes after Phacoemulsification in the patients with diabetics. Methods This randomized study involved 25 patients （28 eyes） with diabetes cataract and 20 patients with cataract who underwent Phacoemulsification, Tear break - up time （BUT）, Schirmer Ⅰ test （Sit） value and corneal fluorescein staining were measured preoperatively and 1 day and 3, 7, 30, 90 days postoperatively. Results At 1 day and 3 and 7 days postoperatively, the subjective complains of dry eye, the mean Sit and fluorescein staining scores increased significantly, and the mean BUT decreased significantly （ P 〈 0.01 for normal group, P 〈 0.05 for diabetes group）. The Bur and Sit recovered at 30 and 90 days postoperatively. 15% of patients in normal group showed shorter BUT and 38. 09% of patients in diabetes group showed BUT instability postoperatively. In addition, the mean BUT of diabetes group was less than that of normal group preoperatively and 30 and 90 days postoperatively （ P 〈 0.001 ）. The score of corneal fluorescein staining of diabetes group was higher titan that of normal group. Conclusions Phacoemulsification reduces the stability of tear film of diabetes patients. Preventions should be taken, like artificial tears.

关 键 词：糖尿病 超声乳化白内障吸除术 泪膜 

分 类 号：R587.1[医药卫生—内分泌]