同轴微切口白内障超声乳化术后泪膜及角膜规则性的研究  

Changes in tear film and corneal surface regularity after coaxial micro-incision phacoemulsification

作　　者：章成芝 徐青[1] 

机构地区：[1]中国人民武装警察部队总医院眼科,北京市100039

出　　处：《眼科新进展》2016年第6期559-562,共4页Recent Advances in Ophthalmology

摘　　要：目的比较1.8 mm和3.0 mm两种白内障手术切口术后泪膜及角膜规则性的变化。方法选取2014年11月至2015年10月行白内障超声乳化吸出术的年龄相关性白内障患者48例(62眼),根据患者对人工晶状体的选择分为:A组24例(30眼)行1.8 mm透明角膜微切口白内障超声乳化术,B组24例(32眼)行3.0 mm透明角膜切口白内障超声乳化术。比较术前及术后1 d、7 d、1个月、3个月的泪膜破裂时间(break-up time,BUT)、基础泪液分泌(SchirmerⅠtest,SⅠt)、角膜荧光素染色评分(cornea fluorescein staining,FLS)、干眼主观症状评分、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)。结果术后1 d、7 d B组BUT均短于A组(均为P<0.05)。术后1 d B组SⅠt低于A组(P<0.05)。术后1 d、7 d、1个月B组FLS均高于A组(均为P<0.05)。术后1 d、7 d B组干眼主观症状评分均高于A组(均为P<0.05)。术后1 d、7 d、1个月B组SAI、SRI均高于A组(均为P<0.05)。A组BUT、FLS、干眼主观症状评分、SAI于术后1个月恢复至术前状态,SⅠt和SRI于术后7 d恢复至术前状态;B组各项结果均于术后3个月恢复至术前状态。结论 1.8 mm切口较3.0 mm切口白内障超声乳化术后干眼症状更轻,泪膜功能及角膜规则性恢复更快。Objective To compare the changes in tear film and corneal surface regularity after 1.8 mm coaxial micro-incision phacoemulsification and 3.0 mm incision coaxial phacoemulsification.Methods From November 2014 to October 2015,48 patients（62 eyes） with age-related cataract were divided into 2 groups according to the IOL selection.Group A（24patients,30 eyes） received 1.8 mm coaxial micro-incision phacoemulsification,and group B（24 patients,32 eyes） took 3.0 mm incision coaxial phacoemulsification.Tear break-up time（BUT）,Schirmer Ⅰ test（SⅠt）,cornea fluorescein staining scores（FLS）,subjective score for dryness,surface regularity index（SRI） and surface asymmetry index（SAI） were evaluated preoperatively and 1 day,7 days,1 month and 3 months postoperatively.Results At 1 day,7 days postoperatively,the mean BUT of group B reduced greatly than group A.At 1 day postoperatively,the mean SⅠt of group B was lower than group A（P〈0.05）.At 1 day,7days and 1 month postoperatively,the mean FLS of group B were higher than group A（all P〈0.05）,At 1 day,7 days postoperatively,the mean subjective score for dryness of group B were higher than group A（all P〈0.05）.At 1 day,7 days and 1 month postoperatively,the mean SAI and SRI of group B were both higher than group A.In group A,BUT,FLS subjective score for dryness and SAI recovered to preoperative levels at 1 month postoperatively,and SⅠt and SRI in group A recovered at 7 days.In group B,all of observing indexes recovered to preoperative levels at 3 months postoperatively.Conclusion 1.8 mm coaxial micro-incision phacoemulsification has the slighter dry eye symptom,faster recovery of tear film and corneal surface regularity than 3.0 mm incision coaxial phacoemulsification.

关 键 词：微切口白内障超声乳化术 泪膜 干眼 角膜规则性 

分 类 号：R779.66[医药卫生—眼科]