白内障超声乳化术后局部用药治疗白内障患者干眼症的临床效果

Clinical effect of local drug after phaco in treating cataract patients with dry eyes

目的探讨白内障超声乳化术后局部用药治疗白内障患者干眼症的临床效果。方法收集2012年3月~2014年3月来辽宁省盘锦市中心医院眼科接受治疗的白内障患者190例（200眼）,将其分为研究组（95例,100眼）和对照组95例（100眼）,术前常规检测患者,同时给予两组超声乳化术治疗,术毕研究组妥布霉素地塞米松滴眼液及贝复舒滴眼液点眼,4次/d,每5天递减1次,共计20 d。对照组予妥布霉素地塞米松滴眼液,同时予以同规格的贝复舒滴眼液点眼,5次/d,每4天递减1次,共计20 d。观察干预后1周、1个月、3个月的干眼症状、角膜荧光素染色及泪膜破裂时间（BUT）评分。结果研究组术后3个月干眼症状评分为（0.74±0.06）分,明显低于其术后1周[（1.21±0.14）分]、术后1个月[（1.09±0.33）分]及对照组术后3个月[（1.48±0.05）分],差异均有统计学意义（P〈0.05或P〈0.01）;研究组术后3个月角膜荧光染色评分为（0.71±0.02）分,明显低于其术后1周[（1.81±0.11）分]、术后1个月[（1.39±0.30）分]及对照组术后3个月[（1.42±0.01）分],差异均有统计学意义（P〈0.05或P〈0.01）;研究组术后3个月BUT评分为（8.70±0.10）分,明显高于其术后1周[（4.21±0.15）分]、术后1个月[（7.38±0.20）分]及对照组术后3个月[（6.47±0.12）分],差异均有统计学意义（P〈0.05或P〈0.01）。研究组干眼症状发生率为1.1%,明显低于对照组（5.3%）,差异有统计学意义（P〈0.05）。结论白内障患者超声乳化术后局部用药在改善并恢复泪膜功能上作用显著,且安全性高,但其要遵循一定的用药原则,选择合理的用药方式,在保证控制术后感染前提下,尽量减少点眼的频率及用药量。

Objective To explore clinical effect of the local drug after phaco in treating cataract patients with dry eyes.Methods From March 2012 to March 2014, in Department of Ophthalmology, Center Hospital of Panjin City, 190 cataract patients（200 eyes） were collected, and divided into research group（95 cases, 100 eyes） and the control group（95 cases, 100 eyes）. All patients were given preoperative routine detection and phaco treatment, after operation, research group was given Tobramycin and Dexamethasone Eye Drops and Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops, 4 times/d with once every 5 days decline for 20 days. Control group was given Tobramycin and Dexamethasone Eye Drops and Recombinant Bovine Basic Fibroblast Growth Factor Eye Drops, 5 times/d with once every 4 days decline for 20 days. The dry eye symptoms, corneal fluorescein staining and appears burst time（BUT）score after intervention after 1 week, 1 month, 3 months of two groups were observed. Results After 3 months, dry eye symptoms score of research group was（0.74±0.06） scores, which was significantly lower than those ater the operative 1week [（1.21±0.14） scores], afer operative 1 month [（1.09 ±0.33） scores], and that of the control group after 3 months[（1.48±0.05） scores], the differences had statistical significance（P〈0.05 or P〈0.01）. After 3 months, corneal fluorescent dye score of research group was（0.71±0.02） scores, which was significantly lower than those after operative 1 week[（1.81±0.11） scores], after operative 1 month [（1.39±0.30） scores], and that in the control group after 3 months [（1.42 ±0.01） scores], the differences had statistical significance（P〈0.05 or P〈0.01）. After 3 months, BUT score of research group was（8.70±0.10） scores, which was significantly lower than those after operative 1 week [（4.21±0.15） scores], after operative 1 month [（7.38±0.20） scores], that of the control group after 3 months [（6.47±0.12） scores], the differences had statistical significance（P〈0.05 or P〈0.01）. The incidence of dry eye symptoms in the research group was 1.1%,which was obviously lower than that in the control group（5.3%）, the difference was statistically significant（P〈0.05）.Conclusion The effect of local drug of phaco in the treatment of cataract patients with dry eyes is significant on improving and restoring function with high safety, but the drug must follow the certain principle, selecting rational way of drug use,under the premise that ensure control of postoperative infection, it should reduce the frequency and dosage of the eye.