白内障超声乳化术对泪膜功能的影响  

Changes of lacrimal film after phacoemulsification

作　　者：李晓鹏[1] 李彦[1] 焦军杰[1] 王爽[1] 刘静[1] 

机构地区：[1]新乡医学院第三附属医院眼科,中国河南省新乡市453003

出　　处：《国际眼科杂志》2015年第4期669-671,共3页International Eye Science

摘　　要：目的:观察白内障超声乳化吸除联合人工晶状体植入手术对于患者术后泪膜的影响,探讨其临床意义。方法:随机选取接受超声乳化白内障吸除术治疗的患者106例140眼,观察患者术前;术后1d;1,2,3wk;1mo这六个时间节点的主观干燥异物感,通过角膜荧光素试验(FSC)、基础泪液分泌试验(SⅠt)和泪膜破裂时间(BUT)这三个指标测定患者的泪膜功能变化,并分析泪膜稳定性和角膜知觉之间的相关性。结果:患眼术后1d;1,2wk干眼症状累计得分高于术前(t=8.53,P=0.000;t=6.27,P=0.000;t=9.02,P=0.000),患眼术后3wk和1mo干眼症状累计得分与术前相比无差异(t=1.91,P=0.824;t=1.27,P=0.069)。患眼术后1d;1,2wk角膜上皮荧光素染色点与术前相比增多(t=11.64,P=0.000;t=9.61,P=0.000;t=8.87,P=0.001),患眼术后3wk和1mo角膜上皮荧光素染色点与术前相比无差异(t=2.52,P=0.746;t=1.16,P=0.094)。患眼术后1d;1,2wk角膜知觉检测数值明显大于术前(t=9.61,P=0.000;t=9.27,P=0.000;t=11.39,P=0.024),术后3wk和1mo角膜知觉检测结果数值与术前相比无差异(t=1.19,P=0.562;t=2.17,P=0.501)。结论:白内障超声乳化吸除联合人工晶状体植入术会在短期内降低术眼泪膜的稳定性,但是在长期休养之后会得到一定程度上的改善。AIM： To observe of cataract phacoemulsification and intraocular lens implantation in patients with postoperative tear film, and to explore its clinical significance.METHODS： A total of 106 patients（ 140 eyes）undergone phacoemulsification were randomly chosen.Subjective dry foreign body sensation were observed at six nodes of period 1d,1,2,3wk,and 1mo. Corneal fluorescein（ FSC）,basal tear secretion（ SIT） and tear film break- up time（ BUT） were used to detect functional changes of the tear film. And the correlation between tear film stability and corneal sensitivity was analyzed.RESULTS： Dry eye cumulative score of postoperative1 d,1,2wk was higher than preoperative（ t = 8. 53,P =0. 000; t =6. 27,P = 0. 000; t = 9. 02,P = 0. 000）. There was no significant difference in dry eye cumulative score at postoperative 3wk,1mo compared with preoperative（ t =1. 91,P = 0. 824; t = 1. 27,P = 0. 069）. Corneal epithelial fluorescein staining points of postoperative 1d,1,2wk were increased compared with preoperative（ t = 11. 64,P=0. 000; t = 9. 61,P = 0. 000; t = 8. 87,P = 0. 001）. There was no significant difference in corneal epithelial fluorescein staining points of postoperative 3wk and 1mo compared with preoperative（ t =2. 52,P = 0. 746; t = 1. 16,P = 0. 094）. Corneal sensitivity detection values of postoperative 1d,1,2wk were significantly higher than that of preoperative（ t = 9. 61,P = 0. 000; t = 9. 27,P = 0.000; t = 11. 39,P = 0. 024）,and there was no difference postoperative 3wk and 1mo compared with preoperative（=1. 19,P =0. 562; t =2. 17,P =0. 501）.CONCLUSION： Phacoemulsification with intraocular lens implantation will reduce the tear film stability in the short term,but after a long rest will be improved to a certain extent.

关 键 词：白内障 超声乳化 泪膜功能 角膜知觉 

分 类 号：R779.66[医药卫生—眼科]