两种不同术式白内障摘除术后泪膜稳定性的检测  

Investigation on the tear film stability after two types of cataract extractions

作　　者：蓝倩倩[1] 陈琦[1] 满平仪[1] 曾思明[1] 

机构地区：[1]广西壮族自治区人民医院眼科,中国广西壮族自治区南宁市530021

出　　处：《国际眼科杂志》2016年第2期246-249,共4页International Eye Science

基　　金：广西壮族自治区卫生厅自筹经费科研课题(No.Z2013398)~~

摘　　要：目的:利用角膜地形综合分析仪评估两种不同术式白内障摘除术后的泪膜稳定性和干眼情况。方法:选择年龄相关性白内障患者67例88眼,接受白内障超声乳化摘除(phacoemulsification,Phaco)联合人工晶状体植入术者35例46眼纳入Phaco组,接受非超声乳化小切口白内障囊外摘除(extracapsular cataract extraction,ECCE)联合人工晶状体植入术者32例42眼纳入ECCE组,用角膜地形综合分析仪定量分别测量各组术前和术后1d,1、3mo的首次非侵犯性泪膜破裂时间(the first noninvasive tear break-up time,f NIBUT)、平均非侵犯性泪膜破裂时间(the average non-invasive tear break-up time,aN IBUT)、泪河高度(tear meniscus height,TMH),统计TMH异常的比例、泪膜稳定性分级中诊为"干眼"的比例,并进行统计学分析。结果:术后1d,Phaco组的f NIBUT、aN IBUT、TMH均高于ECCE组,Phaco组干眼比例低于ECCE组;术后1mo Phaco组的aN IBUT仍高于ECCE组,术后3mo两组各指标差异均无统计学意义(P>0.05);Phaco组,与术前比较,aN IBUT术后1d下降,TMH术后1d和1mo下降,TMH异常比例术后1mo升高;ECCE组,与术前比较,aN IBUT和TMH在术后1d和1mo均下降,TMH异常比例在术后1d和3mo升高,干眼比例在术后1d和1mo升高。结论:用角膜地形综合分析仪评估发现,ECCE对泪膜的影响时间较Phaco长,术后的干眼状态持续更久。AIM：To investigate the tear film stability and dry eye after two types of cataract extractions by Oculus Keratograph.METHODS：Eighty-eight eyes in 67 patients with age related cataract were included in the study.Forty-six eyes in 35 patients underwent phacoemulsification（Phaco）combined with intraocular lens implantation as Phaco group,while 42 eyes in 32 patients underwent non-phacoemulsification small incision extra-capsular cataract extraction（ECCE） combined with intraocular lens implantation as ECCE group.The first non-invasive tear break-up time（fNIBUT）,the average non-invasive tear break-up time（aNIBUT）,the tear meniscus height（TMH）and the proportion of ＂ dry eye＂ diagnosised in tear film stability grades before operations and at 1d,1 and 3mo after operations were recorded and analyzed.RESULTS：The fNIBUT,aNIBUT,TMH in Phaco group were higher than those in ECCE group,while the proportion of dry eye in Phaco group were lower than that in ECCE group at 1d postoperatively.The aNIBUT in Phaco group was still higher than that in ECCE group at 1mo postoperatively.The differences on these indicators between two groups were not statistically significant at3 mo postoperatively.Compared with that preoperatively,aNIBUT was reduced at 1d postoperatively,TMH was reduced at 1d and 1mo postoperatively,while the ratio of patients with abnormal TMH was increased 1mo postoperatively in Phaco group.The aNIBUT and TMH were reduced at 1d and 1mo postoperatively,the ratio of patients with abnormal TMH was increased at 1d and 3mo postoperatively,while the proportion of dry eye was increased at 1d and 1mo postoperatively in ECCE group.CONCLUSION：ECCE has more negative effects on the tear film stability than Phaco,which causes longer dry eye according to the Oculus Keratograph.

关 键 词：白内障囊外摘除术 白内障超声乳化摘除术 干眼 角膜地形综合分析仪 

分 类 号：R779.66[医药卫生—眼科]