超声乳化白内障手术两种不同切口术后干眼的临床分析  

Clinical analysis of the dry eye after phacoemulsification in two different incisions

作　　者：岳艳菊[1] 吴华[1] 

机构地区：[1]信阳职业技术学院附属医院眼科,河南464000

出　　处：《中国实用眼科杂志》2016年第5期443-446,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨超声乳化白内障手术两种不同切口对术后干眼的影响.方法 临床病例对照研究.对2013年7月至2014年12月,在信阳职业技术学院附属医院眼科,选择行超声乳化白内障吸除术的非干眼患者146例（160只眼）.按随机表方法随机分为A组和B组,A组72例（80只眼）采用巩膜隧道切口;B组74例（80只眼）采用透明角膜切口.观察术前、术后1天、1周、1月及3月的干眼相关指标,包括主观症状问卷调查、泪膜破裂时间（BUT）、角膜荧光素染色（FL）和基础泪液分泌试验（SIt）检查.结果 比较术前、术后1天、1周A、B两组的干眼症状评分增加、BUT缩短、FL评分增加,差异均有统计学意义（P＜0.01）,术后1月、3月差异均无统计学意义（P＞0.05）.A、B两组间比较,术后1天、1周,B组的干眼症状评分增加、BUT缩短、FL评分增加,两组比较差异均有统计学意义（P＜0.01）;术后1月、3月两组比较差异均无统计学意义（P＞0.05）.SIt术后A、B两组各观察时间点均较术前增加,差异均有统计学意义（P＜0.01）;A、B两组间比较,术后1天,A组SIt增多较B组明显,差异有统计学意义（P＜0.01）;其他时间点两组SIt差异均无统计学意义（P＞0.05）.结论 超声乳化白内障手术采用巩膜隧道切口和透明角膜切口均引起患者术后早期干眼发生,透明角膜切口较巩膜隧道切口引起术后早期干眼程度更加严重.Objective To investigate the effect of different incisions on the dry eye after phacoemulsification.Methods Tear film was monitored in 146 cases （160 eyes） after phacoemulsification.Patients were divided into two groups according to the type of incision：group A （72 cases,80 eyes） with a sclerotic tunnel incision and group B （74 cases,80 eyes） with a clear corneal incision.Symptoms of dry eye,break-up time （BUT）,comea fluorescein staining （FL） and schirmer Ⅰ test （SIt） were observed preoperatively and 1 day,1 week,1 month,and 3 months postoperatively.Resu1ts For groups A and B,the dry eye symptom and FL scores were increased and the BUT reduced 1 day and 1 week postoperatively.And all the differences were statistically significant （P 〈0.01）.Nevertheless,no statistically significant differences were found either 1 or 3 months postoperatively （P 〉0.05）.In addition,group B showed more distinct changes in eye symptom,BUT and FL scores compared to groups A 1 day and 1 week postoperatively.And all the differences were statistically significant （P 〈0.01）.Consistently,the statistical difference was not significant 1 month or 3 months later （P 〉0.05）.After the operation,both groups had elevated SIT with statistical significance at all the four time points mentioned above （P 〈0.01）.Furthermore,group A displayed a higher elevation of SIt than group B on 1 day postoperatively with statistical significance （P 〈0.01）,whereas no statistical differences were observed at the other postoperatively time points （P 〉0.05）.Conclusions The scleral tunnel and clear corneal incisions from phacoemulsification may cause dry eye syndrome in the early stage of postoperatively.Particularly,the clear corneal incisions can induce severer syndrome than the scleral tunnel incisions.

关 键 词：超声乳化白内障吸除术 巩膜隧道切口 透明角膜切口 干眼 

分 类 号：R779.66[医药卫生—眼科]