老年性白内障术后屈光状态对眼表的影响  

Ocular surface effect of refractive status after cataract phacoemulsification

作　　者：郭元懿[1] 李若溪[1] 

机构地区：[1]沈阳市第四人民医院眼科,沈阳110031

出　　处：《中国实用眼科杂志》2016年第11期1156-1159,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的了解老年性白内障术后不同屈光状态眼表的特点，探讨白内障术后干眼症的治疗方法。方法临床病例对照研究。将2015年2月至2015年10月在沈阳市第四人民医院眼科就诊的老年性白内障行超声乳化联合人工晶状体植入术后轻度屈光不正和正视眼的患者。按术后6个月的屈光状态分为轻度近视组、轻度远视组、轻度散光组和正视眼组，每组各60例，共240例，并对每组患者治疗前，治疗后6个月的矫正视力，泪液分泌试验（Schirmer Test）、泪膜破裂时间（BUT）、角膜荧光素染色（FL）等检查进行分析。结果术后轻度散光组BUT明显小于轻度近视和轻度远视组，轻度远视组BUT明显小于轻度近视组，差异有统计学意义（P 〈0.05）。术后散光组的干眼发病率最高，其次是轻度远视组，差异有统计学意义（P 〈0.05）。结论老年性白内障术后的屈光状态对眼表泪膜有影响，主要表现为BUT缩短。白内障术后应及时矫正屈光不正，尽量避免散光及远视的发生。这对改善老年性白内障患者术后的眼表状态及视觉质量至关重要。Objective To investigate the characteristics of ocular surface after senile cataract sur- gery with different refractive status, to explore methods for the treatment of dry eye after cataract surgery. Methods A clinical case-control study. A total of 240 senile cataract cases （60 cases for each group） received treatment of phacoemulsification combined with intraocular lens implantation in Shenyang Fourth People＇s Hospital from February 2015 to October 2015 with mild amblyopia and emmetropia were collected. According to the postoperative 6 months of refractive status points, the patients were divided into mild myopia group, mild hypermetropia group, mild astigmatism group and emmetropia group. The corrected visual acuity, Schirmer test （Schirmer test）, BUT （break-up time）, FL （corneal fluorescein staining） examination at before treatment, 6 months after treatment were analyzed. Results Postoperative BUT on mild astigmatism group was significantly less than mild myopia and mild hypermetropia group, and BUT on mild hypermetropia group was significantly less than mild myopia group （P 〈0.05）, the difference was statistically significant. Postoperative dry eye on astigmatism group had the highest incidence, followed by mild hyperopia group, the difference was statistically significant. Conclusions After cataract surgery, refractive status on tear film effects, mainly for the BUT （tear break-up time） are shortened. Refractive errors should be timely corrected after cataract surgery to avoid the occurrence of hyperopia and astigmatism. The improve- ment of ocular surface and visual quality after phacoemulsification in cataract patients is very important.

关 键 词：白内障 屈光不正 泪膜 眼表 

分 类 号：R776.1[医药卫生—眼科]