人工泪液对年龄相关性白内障术后患者泪膜的影响

The effect of artificial tears on tear film changes after phacoemulsification and intraocular lens implantation

目的:观察超声乳化白内障吸除术前后泪膜的变化和应用人工泪液对泪膜的影响。方法:行超声乳化白内障吸除术的年龄相关性白内障患者120例120眼,按同期配对原则分为对照组(A组)和治疗组(B组),对照组(60眼)术后给予常规治疗,治疗组(60眼)术后给予常规治疗和人工泪液(1g/L透明质酸钠)点眼,分别于术前,术后1,7,14,30及90d行泪膜干涉成像法、基础泪液分泌试验(SchirmerⅠtest,SIt)、泪膜破裂时间(breakuptime,BUT)检查。结果使用SPSSV13.0分析。结果:术前两组泪膜干涉图象等级、SchirmerⅠ检查、BUT3个检查值差异无统计学意义(P>0.05)。A组与术前比较,术后1dBUT明显缩短,泪膜干涉图象等级、SchirmerⅠ检查明显增高(P<0.01);7d时SchirmerⅠ检查,30d时BUT,泪膜干涉图象等级恢复至术前水平(P>0.05)。B组与术前比较,术后1dBUT缩短,泪膜干涉图象等级,SchirmerⅠ检查增高(P<0.01);7d时SchirmerⅠ检查,14d时BUT和泪膜干涉图象等级恢复至术前水平(P>0.05)。B组较A组,术后1d,泪膜干涉图象等级明显降低,BUT明显延长(P<0.01);至术后30d,两组泪膜干涉图象等级和BUT无显著性差异(P>0.05)。术后1,90d两组SchirmerⅠ检查,始终没有显著性差异(P>0.05)。结论:白内障超声乳化术后早期使用人工泪液利于泪膜恢复。

AIM： To evaluate tear film changes before and after phacoemulsification and the effect of artificial tears on the tear film after phacoemulsification and intraocular lens （IOL） implantation. METHODS： A total of 120 consecutive patients （120 eyes） with age-related cataract undergoing phacoemulsification and IOL implantation were divided into control group （group A, 60 eyes with conventional therapy） and treatment group （group B, 60 eyes with conventional therapy and artificial tears） according to the age and sex matching principle. Tear film pattern by DR-1 tear interfermetry, Sit test （Sit） value and tear break-up time （BUT） were measured preoperatively and 1 day and 7, 14, 30, 90 days postoperatively. RESULTS： No significant differences existed between the two groups before operation （P〉0.05）. In group A, the BUT reduced greatly （P〈0.01）, the grades of tear film pattern and Sit value increased significantly at postoperative 1 day （P〈0.01）; Sit value returned to the preoperative value at postoperative 7 days （P〉0.05）, so did the grades of tear film pattern and BUT at postoperative 30 days （P〉0.05）. In group B, the BUT reduced greatly （P〈0.01）, and the grades of tear film pattern and Sit value increased significantly （P〈0.01） at postoperative 1 day; Sit value returned to the preoperative value at postoperative 7 days （P〉0.05）, so did the grades of tear film pattern and BUT at postoperative 14 days （P〉0.05）. At postoperative 1 day, the grades of tear film pattern were significantly higher and BUT were significantly longer in group B than in group A （P〈0.01）. At postoperative 30 days, the grades of tear film pattern and BUT had no significant differences between the two groups （P〉0.05）, neither was there significant difference on the Sit value between the two groups at postoperative 90 days （P〉0.05）. CONCLUSION： The stability of tear film decreased in early period after phacoemulsification, and artificial tears can accelerate the recovery of tear film.