透明角膜及巩膜隧道切口行白内障超声乳化术对泪膜的影响  

Changes of tear film after phacoemulsification with clarity corneal incision or sclera tunnel incision

作　　者：江利红[1] 史春[1] 张靖华[1] 应坚[1] 

机构地区：[1]中国上海市杨浦区市东医院眼科,200438

出　　处：《国际眼科杂志》2009年第7期1303-1304,共2页International Eye Science

摘　　要：目的:探讨经透明角膜及经巩膜隧道两种不同切口行白内障超声乳化联合人工晶状体植入术后泪膜的情况。方法:选择术前无干眼症单纯老年性白内障患者108例128眼,随机分组:A组55例68眼经透明角膜切口行白内障超声乳化联合人工晶状体植入术;B组53例60眼经巩膜隧道切口行白内障超声乳化联合人工晶状体植入术。观察分析术前、术后l,7,30,90d的所有患者干眼症状评分,基础泪液分泌试验(SⅠt),泪膜破裂时间(BUT),角膜荧光素染色情况。结果:两组术前各项干眼指标差异无统计学意义(P>0.05),所有术眼SⅠt值术后1d增加,术后7,30d下降,术后1,7,30d干眼症状评分增高,BUT缩短、角膜荧光素染色增加,较术前差异均有统计学意义(P<0.05),而两组比较术后1,7,30d,A组干眼症状评分高,SⅠt值改变大,BUT短、角膜荧光素染色多,较B组差异有统计学意义(P<0.05);术后90d时,所有术眼干眼症状评分、SⅠt值、BUT程度及角膜荧光素染色接近术前水平,两组差异无统计学意义(P>0.05)。结论:相对于经巩膜隧道切口,经透明角膜切口的白内障超声乳化联合人工晶状体植入术术后短期对泪膜的影响较大,临床上应积极采取预防措施。AIM ： To study the changes of tear film after phacoemul- sification combined with intraocular lens implantation through clarity corneal incision or sclera tunnel incision. METHODS： One hundred and eight cases （128 eyes） with age-related cataract who hadn＇t got dry eye syndrome before the operations were randomly divided into two groups. There were 55 cases （68 eyes） through clarity corneal incision in group A,and 53 cases （60eyes） through sclera tunnel incision in group B. The subjective complains of dry eye, Schimer Ⅰ test （S Ⅰ t）, tear break- up time （BUT） and corneal fluorescein staining value were analyzed preoperatively and 1 day,7 days,30 days,90 days postoperatively. RESULTS： The two group data of subjective complains of dry eye, S Ⅰ t, BUT and corneal fluorescein scores were all statistical significance （ P 〈 0.05） on the first day, 7 days, 30 days after operation respectively, but 90 days after operation they all recovered their preoperative values, and they had no statistical significance （ P 〉 0.05）. CONCLUSION： Influences of phacoemulsification combined with intraocular lens implantation on tear film stability through clarity corneal incision seems to be more than that through sclera tunnel incision in short period. Protective measure should be taken clinically.

关 键 词：白内障超声乳化术 透明角膜切口 巩膜隧道切口 泪膜 

分 类 号：R779.66[医药卫生—眼科] R776.1[医药卫生—临床医学]