肾移植患者白内障超声乳化术后干眼临床分析

Analysis of dry eye after phacoemulsification in patients of renal transplantation

目的分析肾移植术后患者行超声乳化白内障吸出术后泪液及泪膜的变化，探讨其干眼问题。方法采用非随机病例对照研究设计。肾移植组白内障患者26例（34眼）及单纯年龄相关性白内障患者（对照组）33例（40眼），分别于超声乳化联合人工晶状体（IOL）植入术前术后不同时间，以干眼调查问卷的方式获得患者的主觉症状并进行评分，同时行泪膜破裂时间（BUT）、基础泪液分泌试验（sIt）、角膜荧光素染色检查，对两组患者的上述检测指标进行比较。结果肾移植组术后干眼症状的评分及角膜荧光素染色（FL），泪膜破裂时间（BUT）明显重于对照组，总体差异均有统计学意义（P〈0．05）。但术后3个月FL与术前比较差异无统计学意义（P〉0．05）。结论肾移植患者术后泪膜功能较差，是干眼症的易患人群，行超声乳化术后干眼症状较单纯年龄相关性白内障患者更明显。

Objective To analyze the change of tear film after phacoemulsification in patient with renal transplantation and discuss the problem of dry eye. Methods A non-randomized cases-controlled study was designed. 26 cataract patients with renal transplantation （the experimental group） （34 eyes） and matched 33 patients （40 eyes） with age-related cataract（ control group） were included in this study. Before and after different time phacoemulsification and IOL implantation respectively was performed on the all patients, dry eye-related symptom was surveyed and scored by questionnaire, and tear film break-up time （BUT）, Schirmer I test （Sit） and corneal fluorescein （FL） were examined. Results The experimental group is significantly heavier than control group obviously postoperatively in patients with dry eye symptom score , FL, BUT, the overall differences were statistically significant（ P 〈 0.05 ） , but after 3 months FL preoperatively with no significant difference （ P 〉 0.05 ）. Conclusion Tear film function of renal transplantation patients is poor after cataract phacoemulsification. And are susceptible population for dry eye. Dry eye appears more early and severer in renal transplantation patients after phacoemulsification combined with IOL implantation.