白内障术前使用5%聚维酮碘消毒结膜囊对眼表的影响研究  

Effect of 5%Povidone-iodine disinfection of conjunctival sac on ocular surface before cataract surgery

作　　者：钟探 杨军 何宏 聂轲 陈晓丹 欧阳博文 钟兴武 Zhong Tan;Yang Jun;He Hong;Nie Ke;Chen Xiaodan;Ouyang Bowen;Zhong Xingwu(Hainan Eye Hospital,Haikou 570311,China)

机构地区：[1]海南省眼科医院,海口570311

出　　处：《临床眼科杂志》2024年第3期236-241,共6页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金(82271116);海南省重点研发计划(ZDYF2022SHFZ326)。

摘　　要：目的比较白内障术前使用5%聚维酮碘(PI)消毒结膜囊不同时间对眼表的变化。方法前瞻性临床研究。选择就诊于我院行白内障超声乳化抽吸+人工晶状体植入术患者240例(240只眼),随机、双盲分成30 s组、1 min组和3 min组,每组80只眼。所有患者术前行5%聚维酮碘消毒结膜囊,分别消毒30 s、1 min和3 min。术前和术后1 d、1周、1个月观察首次非侵入性泪膜破裂时间(NIBUTf)、平均非侵入性泪膜破裂时间(NIBUTav)、泪河高度(TTMH)、眼红分析评分(RS)、中央角膜上皮厚度(CCET)、角膜荧光素染色检查(CFS);观察术前、术后1周和术后1个月眼表疾病指数评分(OSDI)。结果RS:30 s组、1 min组和3 min组术后1 d眼红分析评分明显高于术前,1周后炎症反应逐渐减轻,且三组术后1个月眼红分析评分明显低于术后1 d,有统计学意义(P<0.001);CCET:30 s组、1 min组和3 min组术后1 d中央角膜上皮厚度明显高于术前,1周后角膜水肿程度减轻,且三组中央角膜上皮厚度1个月后明显低于术后1 d,有统计学意义(P<0.001);CFS:30 s组、1 min组和3 min组术后1 d角膜荧光染色评分明显高于术前,且术后1个月明显低于术后1 d,基本上恢复到术前基线水平,有统计学意义(P<0.001);OSDI:30 s组、1 min组和3 min组术前术后比较无统计学意义(P>0.05);所有观察指标,三组之间比较,无统计学意义(P>0.05)。结论白内障术前使用5%聚维酮碘消毒结膜囊对相关眼表造成的影响与结膜囊消毒30 s、1 min和3 min时间长短无关。Objective To compare the changes of ocular surface after 5%Povidone-iodine(PI)disinfection of con⁃junctival sac at different times before cataract surgery.Methods Prospective clinical study.240 eyes of Phaco+IOL pa⁃tients who were selected to seek medical treatment in our hospital were randomly and double-blinded into a 30 seconds group,a 1 minute group,and a 3 minute group,with 80 eyes in each group.All eyes were disinfected with 5%povidoneiodine before the operation for 30 seconds,1 minute,and 3 minutes respectively.The First noninvasive tear film break-up time(NIBUTf),Average noninvasive tear film break-up time(NIBUTav),Tear Meniscus Height(TMH),Redness Score(RS)Central corneal epithelial thickness(CCET)and Corneal fluorescein staining(CFS)were observed before and after sur⁃gery at 1 day,1 week and 1 month.The Ocular surface disease index(OSDI)was observed before and after surgery at 1 week and 1 month.Results RS:In the 30 s Group,1 min group,and 3 min group,The first day after surgery RS was sig⁃nificantly higher than that before the operation.The inflammatory reaction was gradually alleviated after 1 week,and the postoperative RS 1 month after the operation was significantly lower than that in1 weekafter the operation(P<0.001).CCET:In the 30 s Group,1 min group,and 3 min group,CCET was significantly higher on the first day after the operation than that before the operation.The degree of corneal edema was alleviatedone week after the operation,and CCET was sig⁃nificantly lower one month after the operation than that on the first day after the operation in the three groups(P<0.001).CFS:The corneal fluorescein staining scores of the 30 s,1 min,and 3 min groups were significantly higher on the first day after surgery than those before surgery.The CFS was significantly lower after 1 month than that on the first day after sur⁃gery,and basically returned to the preoperative baseline level,which was statistically significant.(P<0.001).OSDI:There was no statistical significance in the preoperative and pos

关 键 词：聚维酮碘 白内障 眼表 泪膜 

分 类 号：R779.6[医药卫生—眼科]