白内障术毕结膜囊应用黏弹剂对患者术后早期干眼的预防效果  

Effect of applying an ophthalmic viscosurgical device in conjunctival sac at the end of cataract surgery in alleviating early postoperative dry eye

作　　者：杨斐[1] 李孝纯 于洋 李明武 YANG Fei;LI Xiaochun;YU Yang;LI Mingwu(Department of Ophthalmology,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院眼科,北京市102206

出　　处：《眼科新进展》2022年第1期58-61,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨白内障术毕结膜囊应用黏弹剂对患者术后早期干眼的预防效果。方法本研究为前瞻性随机对照研究。随机选取2020年6月至2021年2月在北京大学国际医院眼科行超声乳化白内障吸除联合人工晶状体植入术的年龄相关性白内障患者95例(114眼)。采用随机数字表法将患者分为黏弹剂组48例(58眼)和对照组47例(56眼)。术毕,黏弹剂组患者结膜囊内滴入黏弹剂,对照组患者结膜囊内滴入平衡盐溶液。术前1周,术后1 d、7 d、30 d依次记录和检测患者主观眼表疾病指数(OSDI)量表评分、泪膜破裂时间(BUT)、眼表染色评分(OSS)、Schirmer I试验值(SIt)。对记录和检测的两组患者各项指标进行统计分析。结果术前两组患者OSDI评分、BUT、角膜与结膜OSS及SIt比较差异均无统计学意义(均为P>0.05)。术后1 d、7 d、30 d两组患者OSDI评分均较术前提高,差异均有统计学意义(均为P<0.05)。术后1 d及30 d,黏弹剂组OSDI评分均低于对照组,差异均有统计学意义(均为P<0.05)。黏弹剂组患者术后1 d及7 d BUT较术前升高,对照组术后1 d BUT较术前降低,差异均有统计学意义(均为P<0.05)。术后1 d及7 d,黏弹剂组患者BUT均高于对照组,差异均有统计学意义(均为P<0.05)。对照组患者角膜OSS在术后1 d、7 d及30 d均高于术前,结膜OSS在术后1 d高于术前;黏弹剂组患者仅角膜OSS在术后1 d高于术前,差异均有统计学意义(均为P<0.05)。术后1 d、7 d及30 d黏弹剂组患者角膜OSS均低于对照组,术后1 d结膜OSS低于对照组,差异均有统计学意义(均为P<0.05)。术后1 d黏弹剂组患者SIt低于对照组,差异有统计学意义(P<0.05)。结论白内障术毕结膜囊应用黏弹剂可以有效减轻患者术后早期干眼症状和体征。Objective To evaluate the effect of applying an ophthalmic viscosurgical device(OVD)in the conjunctival sac at the end of cataract surgery in alleviating early postoperative dry eye.Methods This was a prospective randomized controlled study.A total of 95 age-related cataract patients(114 eyes)who underwent phacoemulsification combined with intraocular lens implantation in Peking University International Hospital from June 2020 to February 2021 were randomly selected and divided into the OVD group(48 patients,58 eyes)and the control group(47 patients,56 eyes).At the end of cataract surgery,OVD was applied in the conjunctival sac of patients in the OVD group,while in the control group,the conjunctival sac was wetted with balanced salt solution.Ocular surface disease index(OSDI)score,tear break-up time(BUT),ocular staining score(OSS),and Schirmer I test(SIt)were recorded and measured 1 week before surgery as well as 1,7,and 30 days after surgery.Data of the two groups were statistically analyzed.Results There were no statistically significant differences in OSDI,BUT,corneal and conjunctival OSS,and SIt between the two groups before surgery(all P>0.05).OSDI in both groups were increased significantly on days 1,7,and 30 after surgery compared with the preoperative values(all P<0.05).OSDI in the OVD group was significantly lower than that in the control group on days 1 and 30 postoperatively(both P<0.05).BUT in the OVD group was higher than the preoperative value on days 1 and 7 postoperatively,while BUT in the control group was lower than the preoperative value on day 1 postoperatively(all P<0.05).BUT in the OVD group was significantly higher than that in the control group on days 1 and 7 postoperatively(both P<0.05).Corneal OSS in the control group was significantly higher than the preoperative value on days 1,7,and 30 postoperatively,and conjunctival OSS was significantly higher than the preoperative value on day 1 postoperatively,while in the OVD group,corneal OSS was significantly higher than the preoperative valu

关 键 词：白内障手术 干眼 黏弹剂 泪膜 

分 类 号：R777.2[医药卫生—眼科]