糖尿病白内障患者晶体乳化术后泪膜功能变化及干眼综合征

Changes of tear film and the occurrence of dry eye syndrome following phacoemulsification in the patients with diabetes

目的观察糖尿病患者白内障术后泪膜的变化。方法随机抽取合并糖尿病的白内障患者112例(130只眼)行超声乳化白内障吸除术,对照组为随机选取的单纯老年性白内障患者50例(50只眼)。分别于术前及术后1 d、7 d、30 d、90 d进行症状、角膜荧光素染色(FL)、泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)调查。结果两组术后1 d、7 d、30 d干涩、异物感加重,与术前比较BUT明显缩短,SIt分泌增加,FL染色率明显增多,差异均有统计学意义(P<0.01)。术后90 d两组BUT及SIt逐渐恢复到术前水平。结论糖尿病患者白内障术后可致泪膜稳定性下降。术后补充人工泪液,促使泪膜功能恢复,对糖尿病患者尤为重要。

Objective To evaluate tear film changes following phacoemulsication in the patients with diabetes. Methods This randomized study involved 112 cases （130 eyes） with diabetic cataract and 50 cases （50 eyes） with cataract who underwent phacoemulsification. Tear break-up time（BUT）, Schinmer Ⅱ test （SIt） value and corneal fluorescein staining （FL） were measured preoperatively and 1, 7, 30 and 90 days postoperatively. Results At 1, 3 and 7 days postoperatively, the subjects complain of dry eye, and the mean SIt （t=-14. 726,-17. 213,-7. 256） and FL scores increased significantly, and the mean BUT （t=25. 366, 22. 1257 17. 148） decreased significantly （all P〈0.01 versus normal group）. The BUT and SIt recovered at 90 days postoperatively. Conclusions Phacoemulsification reduces the stability of tear film of diabetic patients. Preventions with artificial tears should be taken.