年龄相关性白内障超声乳化术后泪膜稳定性变化

Tear film stability after phacoemulsification for age-related cataract

目的: 评价年龄相关性白内障术后不同时间泪膜稳定性的变化,了解年龄相关性白内障患者术后泪膜功能及其影响因素. 方法: 2003-07/2003-12我院住院的年龄相关性白内障患者80例90眼. 采取透明角膜切口超声乳化白内障吸除及折叠式后房型人工晶体植入术;术前、术后1 d, 7 d, 1 mo及3 mo依次行Schirmer试验、SIt、泪膜破裂时间BUT、角结膜荧光素染色并对其泪膜稳定性的变化进行分析. 结果: 与术前相比,术后1～2 d,BUT明显缩短(t=15.816, P<0.001),SIt明显增加(t=10.199, P<0.001),角结膜荧光素染色为(+)伤口处角膜水肿;术后1 wk时SIt测定恢复术前水平,差异无显著意义(t=1.926, P>0.05);术后1 mo BUT测定, 差异无显著意义(t=3.472, P>0.05),角结膜荧光素染色及伤口处角膜水肿基本恢复到术前水平. 结论: 超声乳化白内障吸出术后早期影响泪膜稳定性,部分患者术后出现眼干涩、畏光、视力波动等.

AIM： To evaluate the tear film stability at different times after phacoemulsification for age-related cataract and to estimate the tear film function and relative affective factors. METHODS： This randomized study involved 80 age-related cataract inpatients （90 eyes） from July, 2003 to December, 2003. All the patients underwent phacoemulsification through clear corneal combined with foldable intraocular lens （IOL） implantation. Schirmer I test （Sit）, breakup time （BUT） and corneal fluorescein staining were measured preoperatively and on 1, 7, 30 and 90 d postoperatively. RESULTS： On day 1 and day 2 postoperatively, the BUT reduced greatly （t= 15. 816, P〈0.001 ）, Sit value increased significantly （ t = 10. 199, P 〈 0. 001 ） and corneal fluorescein staining showed positive （ ＋ ）. There existed corneal edema at the incision. Sit value on 7 d postoperatively （t=1.926, P〉0.05） and BUT on 30 d postoperatively （ t=3.4？2, P 〉 0.05） returned to their preoperative values. Corneal fluorescein staining and corneal edema recovered on 30 d postoperatively. CONCLUSION： Phacoemulsification significantly alters the BUT, Sit and corneal fluorescein staining. Some patients experience dry eye after this surgery.