白内障Phaco联合IOL植入术后睑板腺功能形态改变发生状况及CCS影响因素分析  

Analysis of the occurrence of CCS and eyelid gland function after Phaco and intraocular lens implantation

作　　者：边俊杰[1] 蒋慧中[1] 张健[1] 刘大川[1] 杨惠青[1] BIAN Junjie;JIANG Huizhong;ZHANG Jian;LIU Dachuan;YANG Huiqing(Department of Ophthalmology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院眼科,北京100053

出　　处：《西部医学》2025年第3期372-376,共5页Medical Journal of West China

基　　金：北京市属医院科研培育计划(PX2019062)。

摘　　要：目的探讨白内障超声乳化(Phaco)联合人工晶状体(IOL)植入术后睑板腺功能形态改变发生状况及囊袋收缩综合征(CCS)影响因素。方法选取2021年6月—2022年12月我院收治的124例(124眼)行白内障Phaco联合IOL植入术白内障患者,术后124例患者均发生睑板腺功能形态改变,依据患者术后是否合并CCS分为观察组(CCS组,n=12)和对照组(非CCS组,n=112)。比较两组一般资料、最佳矫正视力(BCVA)、敏感度(CSF),统计124例患者手术前后睑板腺功能形态[眼表疾病指数(OSDI)、睑缘形态、睑板腺缺失率、泪膜破裂时间、泪膜脂质层厚度]变化特征,分析患者发生CCS的影响因素。结果观察组病程大于对照组(P<0.05),观察组合并糖尿病、合并青光眼、亲水性IOL比例均高于对照组(P<0.05);术前观察组BCVA、CSF(1.5、6、18 c/d)低于对照组,两组术后3个月BCVA、CSF(1.5、6、18 c/d)与术前相比均升高,且观察组低于对照组(P<0.05);患者术后1周、术后1个月OSDI评分高于术前(P<0.05),术后1周睑板腺开口堵塞、睑缘充血、灰线移位比例高于术前(P<0.05),术后1周、术后1个月泪膜脂质层厚度及泪膜破裂时间均低于术前(P<0.05);进行Logistic回归结果显示,糖尿病、亲水性IOL、青光眼是白内障Phaco联合IOL植入患者术后CCS的独立危险因素(P<0.05)。结论白内障Phaco联合IOL植入患者术后睑板腺功能降低,发生CCS的患者BCVA、CSF不佳,糖尿病、青光眼、亲水性IOL与白内障患者术后发生CCS密切相关。Objective To study the occurrence of changes in meibomian gland function and morphology after phacoemulsification(Phaco)combined with intraocular lens(IOL)implantation and the influencing factors of capsular contraction syndrome(CCS).Methods Selected 124 patients(124 eyes)undergoing cataract from June 2021 to December 2022,12 patients with CCS(CCS,12)as observation group and 112 patients without CCS as control group(non-CCS,112),and the general data,best corrected visual acuity(BCVA)and sensitivity(CSF)of the two groups were compared.The functional morphological changes of meibomian gland in 124 patients before and after surgery were analyzed,and the influencing factors of CCS were analyzed.Results The course of disease in observation group were higher than those in control group(P<0.05),and the proportion of IOL in observation group with diabetes mellitus,glaucoma and hydrophilic water was higher than that in control group(P<0.05).BCVA and CSF(1.5 c/d,6 c/d,18 c/d)in the observation group were lower than those in the control group before surgery,and BCVA and CSF(1.5 c/d,6 c/d,18 c/d)in both groups were increased 3 months after surgery compared with those before surgery(P<0.05).The OSDI score of patients one week and one month after surgery was higher than that before surgery(P<0.05).The proportion of meibomian gland opening blockage,palpebral margin congestion and gray line displacement one week after surgery was higher than that before surgery(P<0.05).The thickness of tear film lipid layer and tear film rupture time of patients one week and one month after surgery were lower than that before surgery(P<0.05).Logistic regression results were as follows:diabetes,hydrophilic IOL and glaucoma were independent risk factors for CCS in patients with cataract Phaco combined with intraocular lens implantation(P<0.05).Conclusion After cataract Phaco combined with intraocular lens implantation,patients with CCS have poor BCVA,CSF,diabetes,glaucoma,and hydrophilic IOL are correlated with CCS in cataract patients.

关 键 词：白内障超声乳化 人工晶状体植入 囊袋收缩综合征 睑板腺功能 最佳矫正视力 青光眼 

分 类 号：R779.66[医药卫生—眼科]