白内障超声乳化并人工晶体植入术对睑板腺功能的影响

STUDY ON THE EFFECT OF PHACOEMULSIFICATION AND INTRAOCULAR-LENS IMPLANTATION ON MEIBOMIAN GLAND FUNCTION

目的探讨白内障超声乳化并人工晶体植入术对睑板腺功能的影响。方法随机选取我院2018年1月至2019年1月接受白内障超声乳化联合人工晶体植入手术的患者60例。采取临床OSDI问卷评分、非接触泪膜破裂时间[NITBUT]测量、睑板腺(MGs)评分、泪膜脂质层厚度检查、睑板腺分泌物评分进行研究。在白内障术前和术后1个月、2个月分3次检测。结果术后1个月和2个月,OSDI量表评分较术前增加[(20.3±13.6)分,P<0.05;(23.2±10.4)分,P<0.05];非接触泪膜破裂时间缩短[(6.5±2.6)s,P<0.05;(6.2±3.6)s,P<0.05];泪膜脂质层厚度下降[(62.1±21.4)nm,P<0.05;(65.7±15.7)nm,P<0.05];术后1个月睑板腺结构评分与术前差异无统计学意义[(2.2±1.6)分,P>0.05],术后2个月评分显著降低[(2.1±1.5)分,P<0.05];术后1个月和2个月睑板腺分泌物性状评分与术前差异无统计学意义(P>0.05)。结论白内障超声乳化并人工晶体植入术对睑板腺存在明确影响,术后患者干眼症状出现或加重,睑板腺腺体丢失,泪膜脂质层厚度下降。远期影响需继续研究。

Objective To explore the effect of phacoemulsification and intraocular lens implantation on the function of meibomian glands.Methods From January 2018 to January 2019,the 60 patients who underwent phacoemulsification combined with intraocular lens implantation were randomly selected.Take clinical OSDI questionnaire score,non-contact tear film rupture time measurement[NITBUT],meibomian gland score(MGs)examination,tear film lipid layer thickness examination,meibomian gland secretion score for research.Before cataract surgery and three tests were performed 1 month and 2 months after the operation.Results At 1 and 2 months after operation,the OSDI scale score increased compared with that before the operation,and the symptoms of dry eye were aggravated[(20.3±13.6)points,P<0.05;(23.2±10.4)points,P<0.05];non-contact tear film rupture time was shortened[(6.5±2.6)s,P<0.05;(6.2±3.6)s,P<0.05];the thickness of the tear film lipid layer decreased[(62.1±21.4)nm,P<0.05;(65.7±15.7)nm,P<0.05];there was no statistical difference between the meibomian gland structure score in the first month after surgery and preoperative Significance[(2.2±1.6)points,P>0.05]2 months after operation,the score decreased[(2.1±1.5)points,P<0.05];there was no significant difference in meibomian gland secretion score at 1 and 2months after operation.Conclusions Cataract phacoemulsification and intraocular lens implantation have a clear effect on the meibomian glands.After the operation,the symptoms of dry eye appear or worsen,the meibomian glands are lost,and the thickness of the tear film lipid layer decreases.The long-term impact needs to continue to be studied.