白内障超声乳化术后泪膜变化与视觉质量相关性研究  

Correlation between tear film changes and visual quality after phacoemulsification

作　　者：邱煜焱 康刚劲 徐曼华 王妍茜 李茂娇 陈映 刘长菊 QIU Yuyan;KANG Gangjin;XU Manhua;WANG Yanxi;LI Maojiao;CHEN Ying;LIU Changju(Department of Ophthalmology,the Affiliated Hospital of Southwest University,Luzhou 646000,Sichuan Province,China;Department of Ophthalmology,Suining Central Hospital,Suining 629000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院眼科,四川省泸州市646000 [2]遂宁市中心医院眼科,四川省遂宁市629000

出　　处：《眼科新进展》2020年第2期148-152,共5页Recent Advances in Ophthalmology

摘　　要：目的观察白内障患者超声乳化手术前后不同时间、术后是否使用人工泪液聚乙二醇滴眼液的泪膜变化情况,并分析其与术后视觉质量的相关性。方法将2017年9月至2018年1月在我院眼科就诊并行白内障超声乳化吸出联合单焦点、非球面人工晶状体植入术的47例患者分为两组:治疗组(26例),术后常规使用妥布霉素地塞米松滴眼液、左氧氟沙星滴眼液、普拉洛芬滴眼液、聚乙二醇滴眼液滴眼;对照组(21例),术后使用妥布霉素地塞米松滴眼液、左氧氟沙星滴眼液、普拉洛芬滴眼液滴眼。2组受试对象均于术前及术后7 d、30 d、90 d分别进行OSDI评分,运用眼表综合分析仪检测泪河高度(tear meniscus height,TMH)、泪膜破裂时间(tear break-up time,BUT),并采用基于双通道技术的视觉质量分析系统获取调制传递函数(modulation transfer function,MTF)截止频率、基础客观散射指数(objective scattering index,OSI)及总OSI,通过计算得出泪膜客观散射指数(tear film objective scattering index,TFOSI)。分析不同时间组间、组内各指标差异及相关性。结果两组患者术后OSI较术前明显降低,术后7 d OSI较术后30 d、90 d增加,术后30 d、90 d比较差异无统计学意义(P>0.05);两组患者术后TFOSI均较术前增大,治疗组术后7 d(1.35±0.71)大于术前(0.79±0.56),术后30 d(0.73±0.40)、90 d(0.70±0.49)与术前比较差异均无统计学意义(均为P>0.05);对照组术后30 d(1.33±0.81)较术后7 d(1.83±0.85)小,而较术前(0.62±0.46)值大,术后90 d(0.75±0.53)与术前比较无明显差异(P>0.05)。两组患者术后MTF cutoff均较术前明显增加,术后7 d较术前大,较术后30 d、90 d小,而术后30 d和90 d无明显差异;两组TFOSI、OSI与MTF cutoff均存在负相关性。结论白内障超声乳化术后患者泪膜稳定性与视觉质量具有相关性,泪膜稳定性的恢复有助于视觉质量的提高。Objective To observe the changes of tear film in cataract patients before and after phacoemulsification with or without polyethylene glycol eye drops after surgery,and analyze its correlation with postoperative visual quality.Methods Totally 47 cataract patients who underwent phacoemulsification combined with monofocal aspherical IOL implantation at our department from September 2017 to February 2018 were randomly divided into two groups:Treatment group(26 patients)routinely received tobramycin dexamethasone eye drops,levofloxacin eye drops,pranoprofen eye drops and polyethylene glycol eye drops after operation,and control group(21 patients)received tobramycin dexamethasone eye drops,levofloxacin eye drops and pranoprofen eye drops after operation.All patients underwent OSDI score before operation,postoperative 7 d,30 d and 90 d.Ocular surface comprehensive analyzer was used to detect tear meniscus height(TMH)and tear break-up time(BUT).Visual quality analysis system based on dual channel technology was used to collect modulation transfer function(MTF)cutoff frequency,basic objective scattering index(OSI)and total OSI,and tear film objective scatter index(TFOSI)was calculated.Intra-and inter-group differences and correlation were analyzed at different time points.Results Postoperative OSI were significantly lower than those before operation in both tow groups,and OSI at postoperative 7 d was higher than that at postoperative 30 d or 90 d,and there was no difference in OSI between postoperative 30 d and postoperative 90 d(P>0.05).Postoperative TFOSI was higher than preoperative value in both groups.In the treatment group,TFOSI was 1.35±0.71 at postoperative 7 d,and which was higher than 0.79±0.56 before operation;TFOSI was 0.73±0.40 at postoperative 30 d and 0.70±0.49 at postoperative 90d,both of which had no difference comparing with preoperative value(both P>0.05).In control group,TFOSI was 1.33±0.81 at postoperative 30 d,which was lower than 1.83±0.85 at postoperative 7 d and higher than 0.62±0.46 before

关 键 词：白内障超声乳化吸出术 泪膜 视觉质量 聚乙二醇滴眼液 

分 类 号：R776[医药卫生—眼科]