白内障术前0．025％聚维酮碘结膜囊消毒对眼表的影响

Influence of 0. 025 % povidone iodine on ocular surface applied in conjunctival sac for cataract preop- erative steriliztion

目的探讨0．025％聚维酮碘（PI）白内障术前结膜囊消毒对眼表的影响。方法60例（60眼）老年性白内障术前用0．025％P10．1ml滴结膜囊消毒30s。分别在手术前3d、术后1d、1周、1个月进行检查。检查项目：裂隙灯显微镜观察眼表情况：泪河高度、泪膜破裂时间（BUT）、角膜上皮染色评分、Schirmer 1试验（sT1）、结膜印迹细胞学检查。白内障手术为超声乳化＋人工晶状体植入术，手术顺利，均由同一人完成。术后均用典必舒滴眼液、玻璃酸钠滴眼液、普拉洛芬滴眼液滴眼。结果术前术后对比泪河高度、Schirmerl试验（ST1）、结膜印迹细胞学检查差异无统计学意义。泪膜破裂时间（BUT）术后1d、1周与术前对比有统计学意义。角膜上皮染色评分术后1d与术前对比差异有统计学意义，术后1周无统计学意义。两者术后1个月与术前对比差异无统计学意义。术前轻度干眼症患者术前BUT与术后1d、术后1周比较有统计学意义，与术后1个月比较差异无统计学意义。角膜染色评分术前与术后1d、1周、1个月差异比较有统计学意义。结论0．025％PI白内障术前结膜囊消毒安全有效，术后早期BUT缩短、角膜上皮染色加重，术后1个月眼表基本恢复正常，术前轻度干眼者，术后表现更为明显，人工泪液可延长使用时间。

Objective To observe the influence of 0. 025% povidone iodine （PI） on ocular surface after dropped in canjunetival sac for preoperative sterilization before cataract surgery. Methods Sixty cataract patients （60 eyes） were treated by conjunctival sac sterilization for 30 seconds with 0. 025% povidone iodine 0.1 ml before cataract surgery. Lacrimal river height, corneal fluorescein staining, tear film break-up time （BUT） , Schirmer＇s I test and conjunctiva impression cytology detection were observed on 3 d before surgery and 1 d, 7 d, 30 d postoperatively. All operations were phacoemulsifieation and intraoeular lens implantation and performed by the same doctor. Then tobradex eye drops, sodium hyaluronate eye drops, pranoprofen eye drops were administered postoperatively. Results There was no statistical difference in lacrimal river height, Schirmer＇s I test, conjunctiva impression cytology detection between preoperative and postoperative. There was statistical difference about BUT among the 1 d, 7 d postoperatively and preoperatively. There was statistical difference in corneal fluorescein staining scores between the 1st day postoperatively and preoperatively. No statistical difference was detected after one week. There was no statistical difference on the 30th day. There was statistical difference in BUT between the 1 d, 7 d postoperatively and preoperatively. There was no statistical difference after one month. There was statistical difference in corneal fluorescein staining scores between preoperative and postoperative 1st day , 1st week and 1st month. Conclusion 0.025% PI is safe for preoperative comjunctival sac sterilization for cataract patient. But the mean BUT reduced and corneal fluorescein staining increased on the postoperative early stage, the ocular surface recover in one month.The symptoms are more common in the patients with dry eye preoperatively, all of which recovered in one month.