高度近视患者白内障超声乳化术对泪膜的影响

Early changes of tear film after phecoemulsification for cataract in high myopia

目的:探讨高度近视患者超声乳化吸除术后早期泪膜的改变。方法:选择59例(70眼)行白内障超声乳化吸除术的高度近视患者(屈光度为-6.00D^-17.25D),观察分析其术前、术后1d、1wk、1,3mo的主观感觉,泪膜破裂时间(break-up time,BUT),基础泪液分泌试验(Schimer试验)和角膜荧光素试验结果。比较各项结果在术后不同时间与术前的差异。结果:与术前相比,患者术后1d,1wk,不适主诉增加,术眼BUT较术前缩短,差异具有显著性(P<0.05),术后3mo接近术前水平,差异无显著性。术后1d、1wk角膜荧光素着色点明显增多,差异具有显著性(P<0.05)。术后3mo接近术前水平,无显著差异。术后1d泪液分泌量增多,差异具有显著性(P<0.05)。术后1wk,1,3mo接近术前水平,差异无显著性。结论:高度近视患者超声乳化吸除术后早期即可出现泪膜异常改变,尤其表现为泪膜稳定性下降,因而,此类人群为干眼的易患人群。

AIM： To study the early changes of tear film after phacoemulsification for cataract in high myopia. METHODS： Fifty-nine patients （70 eyes） with high myopia cataract （diopter -6. 00D- -17. 25D） who had undergone phacoemulsification were randomly selected. The evaluation included subjective complaints of dry eye, tear break-up time （BUT）, Schirmer I test and corneal fluorescein staining were analyzed before surgery and 1 day, 1 week, 1 and 3 months postoperatively. RESULTS： Subjective complaints of dry eye increased and the mean tear break-up time was significantly reduced （P〈0.05） on day 1 and 1 week after operation. However, all values recovered to preoperative levels by the time of the third month follow-up visit. Corneal fluorescein staining score increased greatly when measured at day 1 and 1 week visit （P〈0.05）, but had returned to preoperative values at the third month visit. The mean Sit value increased significantly on day 1 postoperatively （ P 〈 0.05） , and returned to the preoperative value after 1 week. CONCLUSION： During the early stage after phacoemulsification, tear film in high myopia may present abnormal changes, mainly in tear stability. They tend to get dry eyes.