有晶状体眼后房型人工晶状体植入手术对眼表泪膜的影响  

Effect of ICL implantation on the tear film and ocular surface

作　　者：陈海婷[1] 冯雪艳[1] 牛广增[1] 范玉香[1] Chen Haiting;Fen Xueyan;Niu Guangzeng;Fan Yuxiang(Department of Ophthalmology,Cangzhou Central Hospital of Hebei Province,Cangzhou 061000,China)

机构地区：[1]河北省沧州市中心医院眼一科,061000

出　　处：《临床眼科杂志》2021年第3期199-203,共5页Journal of Clinical Ophthalmology

基　　金：河北省沧州市科技计划项目(172302151)。

摘　　要：目的评价有晶状体眼后房型人工晶状体植入(ICL)术后干眼和睑板腺功能障碍的情况。方法前瞻性病例分析。连续收集在我院行ICL V4c手术治疗的屈光不正并完成3个月随访的患者,除ICL手术所需的检查之外,评价并记录术前至术后3个月的眼表疾病指数(OSDI)、Schirmer实验、非侵入性泪膜破裂时间(NIBUT)、睑板腺成像、裂隙灯下睑缘及睑板腺检查、角膜荧光素染色(CFS),进行统计学分析。结果完成随访的107例术眼中,OSDI、睑缘形态、睑板腺分泌、分泌物性状评分在术后1个月时均有升高,术后3个月时部分恢复到术前水平,NIBUT值显著下降,在术后3个月仍未恢复至术前水平。术前干眼症状较重(OSDI评分≥12)的干眼组患者较对照组(OSDI评分<12)相比,Schirmer、NIBUT、UDVA结果更低,而睑缘形态、睑板腺缺失、分泌、睑脂评分及角膜荧光素染色评分更高。在这些指标当中,低Schirmer值、低NIBUT值和高睑脂评分都是ICL术后干眼症状加重的危险因素。结论ICL植入术可能影响眼表微环境及睑板腺功能,对已有干眼的患者可能更加明显。Objective To assess the status of dry eye(DE)and meibomian gland dysfunction(MGD)after posterior chamber Implantable Collamer Lens(ICL)surgery in phakic eyes.Methods Patients with ametropia who underwent ICL V4c surgery and completed 3-month follow-up were enrolled in this prospective case series study.The ocular surface disease index(OSDI),noninvasive breakup time(NIBUT),meibography,slit-lamp examination of the lid margin,corneal fluorescein staining(CFS),and Schirmer I test were examined preoperatively and at 1 month and 3 months postoperatively for statistical analysis.Results Data from a total of 107 eyes were included in the analysis.The OSDI,lid marginal abnormality,and meibomian gland secretion,and meibum quality score all increased significantly at 1 month after the surgery and partially recovered to the preoperative level at 3 months after the surgery,while the NIBUT value significantly reduced with longer follow-up and did not return to the preoperative level at 3 months after the surgery.The results of Schirmer,NIBUT values and UDVA were lower in patients with severe preoperative DE symptoms(OSDI score≥12)than those in the control group(OSDI score<12),while the CFS,lid margin score,MG loss,MG secretion,and meibum quality scores were higher.Low Schirmer,low NIBUT values,and high meibum quality score were risk factors for aggravation of DE symptoms after ICL surgery.Conclusions ICL implantation may affect the ocular surface microenvironment and meibomian gland function,especially for patients with dry eye.

关 键 词：有晶状体眼人工晶状体 干眼症 睑板腺功能障碍 

分 类 号：R779.6[医药卫生—眼科]