白内障超声乳化手术对眼表的影响

Ocular surface changes after phacoemulsification

目的探讨超声乳化白内障吸除术对眼表的影响。方法对68例80眼行超声乳化白内障吸除合并人工晶状体植入术的患者,观察术前、术后1天、1周、1个月、3个月、6个月的干眼症状(干涩感、异物感、烧灼感),泪膜破裂时间(BUT)、基础泪液分泌试验(Schinner′Ⅰ试验)、角膜荧光素染色及眼表虎红染色,并对数据进行统计学分析。结果白内障超声乳化术后1周内患者有明显的干眼症状,术后1天和1周虎红染色和荧光素试验较术前明显增多(P<0.05);而且泪液分泌量术后1周较术前明显减少(P<0.05);术后(1～6)个月接近术前水平(P>0.05)。术后1天、1周和1个且BUT均较术前明显缩短(P<0.05);3～6个月后接近术前水平(P>0.05)。结论超声乳化白内障吸除术对眼表具有一定程度的影响,发生机制与多种因素有关;临床应积极采取预防措施。

Objective To evaluate the ocular surface changes after phacoemulsification and intraocular lens implantation. Methods 80 eyes of 68 cases with age related cataract who underwent phacoemulcsificationwere included in this study. The eyes were observed for subjective complaints of dry eye, tear break up time （BUT）, Schirmer＇s 1 test, corneal fluorescein staining, rosebengal staining preoperatively and 1 day, 1 week, 1 month, 3 months, 6 months postoperatively. The results were analyzed statistically. Results The subjective complaints of dry eye were obvious within 1 week after surgery. Rosebengal and corneal fluorescein staining were more concentrated at 1 day and 1 week postoperatively （P〈 0.05 ）, and the Schirmer＇ s 1 test result was lower at 1 week. No significant changes in Schirmer＇s 1 test, rosebengal and corneal fluorescein staining were found between preoperatively and 1 to 6 months postoperatively （P 〉 0.05）. There were clearly decrease in BUT at 1 day, 1 week, 1 month and relative to the preoperative level at 3 to 6 months postoperatively, Conclusions Phacoemulsification does have some extent of effects on the ocular surface, which respects to multi- factors. Preventions should be taken clinically.