合并糖尿病的白内障患者超声乳化术后泪膜改变

Changes of tear film after phacomulsification in patients with diabetics

目的探讨对合并糖尿病的白内障患者行白内障超声乳化联合人工晶状体植入术后泪膜的改变情况。方法接受白内障超声乳化联合人工晶状体植入术的合并糖尿病的白内障患者72例(78眼,A组),不合并糖尿病的白内障患者112例(128眼,B组),对比观察两组患者术前、术后l、7、30、90 d的干眼症状评分,基础泪液分泌试验(SchirmerⅠtest,SⅠt),泪膜破裂时间(break-up time,BUT),角膜荧光素染色(fluorescein,FL)情况。结果术后1、7、30 d,A组干眼症状评分高,SⅠt值改变大,术后30 d,A组(8.67±5.92)mm,B组(10.45±5.77)mm,BUT短,术后30 d,A组(6.23±3.22)s,B组(9.33±3.53)s,FL多,均较B组差异有统计学意义(P<0.05);术后90 d,所有指标接近术前水平,两组差异无统计学意义(P>0.05)。结论相对于不合并糖尿病的白内障患者,合并有糖尿病的白内障患者行白内障超声乳化联合人工晶状体植入术后短期对泪膜的影响较大,临床上应积极采取预防措施。

Objective To study the changes of tear film after phacomulsification combined with intraocular lens in patients with diabetics. Methods Seventy-two cases （78 eyes） with diabetic cataract in group A, and 112 cases （128 eyes） with age-related cataract in group B were concluded in the study. The subjective complains of dry eye, Schirmer I test （Sit）, tear break-up time （BUT） and corneal fluorescein staining values were analyzed preoperatively and 1, 7, 30, 90 days postoperatively. Results The differences of dry eye, Sit, BUT and corneal fluorescein scores were all significant between the two groups on 1,7, 30 days after the operation respectively （P 〈 0.05）, except 90 days after the operation （P〉0.05）. Sit was （8.67 ±5.92） mm in group A and （10.45 ±5.77） mm in group B on day 30 after the operation. BUT was （6.23 ±3.22） s in group A and （9.33 ±3.53） s in group B. Conclusions Compared with the age-related cataract patients, the diabetic cataract patients had tear film dysfunction. The tear film stability of diabetic cataract reduced in the early stage after phacoemulsification and recovered much slowly. Preventions should be taken clinically. （Chin J Ophthalmol and Otorhinolaryngo1,2010 ,10 ：90-91 ）