干眼患者超声乳化术前人工泪液干预的临床研究

Clinical study of artificial tears on the tear film of patients with dry eye before phacoemulsification

目的观察干眼患者超声乳化手术前使用人工泪液对术后泪膜的影响。方法将52例(60眼)行超声乳化的干眼患者随机分为两组:A组27例(30眼),术前未用泪然眼液滴眼;B组25例(30眼),术前使用泪然眼液。两组术后联合使用典必殊和泪然眼液滴眼,分别于术前第15天、术后第1天、第1周、第1个月、第3个月行干眼主观症状问卷调查、基础泪液分泌试验(Schirmer Ⅰ test,SItⅠ)、泪膜破裂时间(break-up time,BUT)和角膜荧光素染色(cornea fluorescein staining,CFS)检查。采用SPSS10.0统计软件,对数据进行t检验分析。结果①术前第15天:两组干眼症状评分、SItⅠ试验、BUT、CFS评分差异均无统计学意义(P>0.05)。②术后第1天:B组干眼主观症状、CFS评分小于A组,且BUT较A组长,差异有统计学意义(P<0.05);SItⅠ试验检查B组虽有延长,但差异无统计学意义(P>0.05)。③术后第1周:B组干眼主观症状、CFS评分小于A组,且BUT较A组长,差异有统计学意义(P<0.05);SItⅠ检查差异无统计学意义(P>0.05)。④术后第1个月:B组CFS评分小于A组,且BUT较A组长,差异有统计学意义P<0.05);干眼主观症状、SItⅠ检查两组差异无统计学意义(P>0.05)。⑤术后第3个月,两组的干眼主观症状、SItⅠ检查、BUT、CFS评分差异均无统计学意义(P>0.05)。结论干眼患者超声乳化白内障术前使用人工泪液有利于术后早期干眼症状的改善及泪膜恢复。

Objective To evaluate the changes in the tear film and the effects of artificial tears on the tear film of patients with dry eye after phacoemulsification. Methods Fifty-two patients with dry eye （60 eyes） were followed np after phacoemulsification to evaluate tear film. Preoperatively, the B group （30 eyes in 25 cases） was treated with Tear Naturale eyedrops and the A group （30 eyes in 27 cases） was not treated. Postoperatively, both the A and B groups were treated with TobraDex and Tear Naturale eye drops. Symptoms of dry eye, break-up.time （BUT）, and corneal fluores- cein staining （CFS） were observed and measurements were taken with the Schirmer I test （Sit 1 ） at 15 days preoperatively and 1 day, 1 week, 1 month, and 3 months postoperatively. The results were analyzed with a t-test using SPSS 10.0. Results （1）At 15 days preoperatively, there was no statistical difference between the two groups for symptoms of dry eye, Sit I , BUT and CFS （P〉 0.05）. （2）At 1 day postoperatively, there were significant statistical differences between the two groups for symptoms of dry eye, CFS was less and BUT was longer in the B group （P〈0.05）, but there was no statistical difference between the two groups for Sit I （P〉 0.05）. （3）At 1 week postoperatively, symptoms of dry eye and CFS were reduced and BUT was longer in the B group with significant differences （P〈0.05）. There was no statistical difference between the two groups for Sit I （P〉0.05）. （4）At 1 month postoperatively, CFS was less and BUT was longer in the B group with significant sta- tistical differences （P〈0.05）. There were no statistical difference between the two groups for symptoms of dry eye and Sit I （P〉0.05）. （5）At 3 months postoperatively, there was no significant statistical differences for symptoms of dry eye, Sit I , BUT and CFS （P〉 0.05）. Conclusion Using artificial tears before surgery can improve symptoms of dry eye and accelerate the recovery of the tear film.