不同切口大小白内障超声乳化术对Ⅱ型糖尿病患者泪膜及角膜表面规则性的影响  

Effect of different incisions for cataract phacoemulsitication on the regularity of tear film and corneal surface of patients with type Ⅱ diabetes

作　　者：章成芝 徐青[1] 

机构地区：[1]安徽医科大学武警总医院临床学院,北京100039

出　　处：《中华灾害救援医学》2016年第3期133-137,共5页Chinese Journal of Disaster Medicine

摘　　要：目的比较1.8 mm和3.0 mm两种白内障手术切口在Ⅱ型糖尿病患者术后泪膜及角膜规则性的变化,以探讨不同切口大小对合并Ⅱ型糖尿病老年性白内障患者的干眼影响。方法选取合并Ⅱ型糖尿病老年性白内障患者48例55眼,根据患者对人工晶状体的选择分为A、B两组,A组23例26眼行1.8 mm透明角膜切口白内障超声乳化术;B组25例29眼行3.0mm透明角膜切口白内障超声乳化术。观察两组术前及术后1 d、7 d、1个月、3个月的泪膜破裂时间(tear break-up time,BUT)、角膜荧光素染色(cornea fluorescein staining,FLS)、干眼主观症状评分、基础泪液分泌(schirmer I test,SIt)、角膜表面规则性指数(surface regularity index,SRI)及角膜表面非对称性指数(surface asymmetry index,SAI)情况。结果术前两组间BUT、FLS、干眼主观症状评分、SIt、SRI及SAI的比较,差异均无统计学意义。术后1 d、7 d,B组BUT、SIt明显低于A组(P<0.05),FLS值、干眼主观症状评分、SAI明显高于A组(P<0.05)。术后1 d、7 d、1个月、3个月,B组SRI明显高于A组,差异有统计学意义(P<0.05)。A组BUT、SIt、干眼主观症状评分于术后7 d恢复至术前水平(P>0.0125),FLS、SRI于术后1个月恢复至术前水平(P>0.0125),SAI于术后1 d恢复至术前水平(P>0.0125)。B组BUT、SIt、SRI、SAI于术后3个月恢复至术前水平(P>0.0125),FLS、干眼主观症状评分于术后1个月恢复至术前水平(P>0.0125)。结论对于合并Ⅱ型糖尿病白内障拟行超声乳化术的患者,术后短期内1.8 mm切口较3.0 mm切口对泪膜功能及角膜规则性影响更小,患者干眼症状更轻,且恢复更快。Objective To compare changes in tear film and corneal surface regularity of type Ⅱ diabetes patients after coaxial phacoemusification through 1.8 mm and 3.0 mm clear corneal incision, to explore effect of different incision size on dry eye in senile cataract patients with type Ⅱ diabetes. Methods 48 cases of senile cataract patients（55 eyes） with type type Ⅱ diabetes were selected, and were divided into 2 groups（AB） according to their selection of intraocular lens. 23 patients（26 eyes） enrolled in group A were treated with coaxial phacoemusification through 1.8 mm clear corneal incision. And 25 patients（29 eyes） in group B were treated with coaxial phacoemusification through 3.0 mm clear corneal incision. Tear break time（BUT）, cornea fluorescein staining（FLS）, subjective symptom score of dry eye, schirmer I test（SIt）, surface regularity index（SRI） and surface asymmetry index（SAI） of the two groups were evaluated before operation and 1 day, 7 days, 1 month and 3months after operation. Results Before operation, differences of BUT, FLS, subjective symptom score of dry eye, SIt, SRI and SAI between the two groups were not statistically significant. 1 day and 7 days after operation, BUT and SIt in group B were significantly lower than those in group A（P〈0.05）, and FLS, subjective symptom score of dry eye, SAI in group B were significantly higher than those in group A（P〈0.05）. SRI of group B were higher than group A at all time points after operation, the difference was statistically significant（P〈0.05）. In group A, BUT, SIt and subjective symptom score of dry eye recovered to preoperative levels at 7 days after operation（P〉0.0125）, FLS and SRI recovered to preoperative levels at 1 month after operation（P〉0.0125）, and SAI recovered to preoperative level at 1 day after operation（P〉0.0125）. In group B, BUT, SIt, SRI and SAI recovered to preoperative levels at 3 months after operation（P〉0.0125）, FLS and subjective symptom score of dry eye

关 键 词：糖尿病 白内障超声乳化术 泪膜 干眼 角膜表面规则性 

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