术前干眼治疗对白内障合并无症状干眼患者白内障术后眼表指标、睑板腺功能及术后有症状干眼发生率的影响  

Effect of preoperative dry eye therapy on ocular surface indices,meibomian gland function,and the incidence rate of postoperative symptomatic dry eye in patients with cataract and concomitant asymptomatic dry eye after cataract surgery

作　　者：刘兰静 吴海亮 LIU Lanjing;WU Hailiang(Department of Ophthalmology,Beijing Daxing District People′s Hospital,Beijing 102600,China;Department of Ophthalmology,Capital Medical University Electric Power Teaching Hospital,Beijing 100073,China)

机构地区：[1]北京市大兴区人民医院眼科,北京市102600 [2]首都医科大学电力教学医院眼科,北京市100073

出　　处：《广西医学》2023年第14期1685-1689,共5页Guangxi Medical Journal

摘　　要：目的探讨术前干眼治疗对白内障合并无症状干眼患者白内障术后眼表指标、睑板腺功能及术后有症状干眼发生率的影响。方法将80例(80只眼)行白内障手术的白内障合并无症状干眼患者分为观察组和对照组,每组40例(40只眼)。术前2周,给予观察组患者干眼治疗,对照组则不做任何相关处理。比较两组患者术前2周(t_(1))、术前1 d(t_(2))、术后1周(t_(3))、术后1个月(t_(4))的眼表疾病指数(OSDI)量表评分、泪膜破裂时间(BUT)、泪液分泌试验(SIT),以及角膜荧光染色(CFS)阳性发生率、睑板腺功能异常发生率。记录两组患者t_(3)、t_(4)的有症状干眼及睑板腺功能障碍的发生情况。结果(1)与t_(1)相比,观察组t_(2)的OSDI量表评分降低,SIT结果及BUT均延长;与t_(2)相比,两组t_(3)、t_(4)的OSDI量表评分均升高,SIT结果及BUT均缩短(均P<0.05)。观察组t_(3)的OSDI量表评分低于对照组,t_(2)、t_(3)的BUT均长于对照组(均P<0.05)。(2)观察组t_(2)的睑板腺功能异常发生率低于t_(1),而t_(4)的睑板腺功能异常发生率高于t_(2),且观察组t_(2)、t_(3)的睑板腺功能异常发生率均低于对照组(均P<0.05),而两组各时间点的CFS阳性发生率差异均无统计学意义(均P>0.05)。(3)观察组t_(4)的有症状干眼发生率低于对照组,t_(3)、t_(4)的睑板腺功能障碍发生率均低于对照组(均P<0.05)。结论术前干眼治疗可以明显减轻白内障合并无症状干眼患者术后早期的干眼症状,改善泪膜稳定性,减少术后睑板腺功能障碍和有症状干眼的发生。Objective To investigate the effect of preoperative dry eye therapy on ocular surface indices,meibomian gland function,and the incidence rate of postoperative symptomatic dry eye in patients with cataract and concomitant asymptomatic dry eye after cataract surgery.Methods Eighty patients(80 eyes)with cataract and concomitant asymptomatic dry eye who underwent cataract surgery were divided into observation group or control group,with 40 cases(40 eyes)in each group.Before 2 weeks of operation,the observation group received dry eye therapy,and the control group did not receive any treatment.The ocular surface disease index(OSDI)scale score,break-up time of tear film(BUT),SchirmerⅠtest(SIT),and positive incidence rate of corneal fluorescein staining(CFS),incidence rate of meibomian gland function abnormality at_(2)weeks before operation(t_(1)),1 day before operation(t_(2)),1 week after operation(t_(3)),and 1 month after operation(t_(4))were compared between patients of the two groups.The occurrence of symptomatic dry eye and meibomian gland dysfunction in patients of both groups was recorded at t_(3)and t_(4).Results(1)Compared with t_(1),the observation group yielded a decreased OSDI scale score at t_(2),and increased SIT result and BUT at t_(2);moreover,compared with t_(2),both groups exhibited an elevated OSDI scale score,and decreased SIT result and BUT at t_(3)and t_(4)(all P<0.05).The observation group interpreted a lower OSDI scale score as compared with the control group at t_(3),and longer BUT as compared with the control group at t_(2)and t_(3)(all P<0.05).(2)The observation group depicted a decreased incidence rate of meibomian gland function abnormality at t_(2)as compared with at t_(1),while the incidence rate of meibomian gland function abnormality at t_(4)was higher than that at t_(2),and the observation group yielded a lower incidence rate of meibomian gland function abnormality as compared with the control group at t_(2)and t_(3)(all P<0.05),whereas no statistically significant difference in CFS po

关 键 词：无症状干眼 白内障 眼表疾病指数量表 泪膜破裂时间 泪液分泌试验 角膜荧光染色 睑板腺功能障碍 

分 类 号：R779.66[医药卫生—眼科]