1.8mm同轴微切口白内障超声乳化吸除术对眼表和泪膜的影响

Changes in ocular surface and tear film following 1.8 mm coaxial microincision phacoemulsification

目的比较1.8 mm透明角膜微切口与3.2 mm透明角膜小切口白内障超声乳化吸除术后对眼表和泪膜的影响。方法 85例(117只眼)随机分为两组:微切口组59只眼,行1.8 mm透明角膜切口白内障超声乳化吸除术,小切口组58只眼,行3.2 mm透明角膜切口白内障超声乳化吸除术。术前、术后1、7、30、90 d分别进行眼表疾病指数问卷(OSDI)、泪膜破裂时间(BUT)和Schirmer I试验(STI)检查。比较两组术前和术后不同时间点检查结果的差异。结果微切口组和小切口组术后1 d BUT缩短、STI增高,术后7 d BUT和STI缩短、OSDI增高,差异均具有统计学意义(P<0.05)。微切口组术后1 d和7 d BUT较小切口组高,术后7 d OSDI较小切口组低,术后7 d STI较小切口组高,差异均具有统计学意义(P<0.05)。结论 1.8 mm同轴微切口白内障超声乳化吸除术对术后眼表和泪膜的影响较小。

Objective To observe and compare the changes in ocular surface and tear film in patients after clear corneal incision phacoemulsification with 1. 8 mm and 3. 2 mm incisions. Methods A prospective randomized controlled study. 117 eyes of 85 patients with age-related cataract in our hospital were divided into two groups： 59 eyes in the 1. 8 mm microincision group and 58 eyes in 3. 2 mm small incision group. All patients received phacoemulsification and intraocular lens implantation. OSDI（ Ocular Surface Disease Index）,Schirmer I test without anesthesia（ SIT）,tear film break-up time（ t-BUT） were assessed preoperatively and postoperatively at 1,7,30 and 90 days. Results Postoperative t-BUT decreased but STI improved in both 1. 8 mm microincision group and 3. 2 mm small incision group 1 day after the surgery. At the 7th day,t-BUT and STI decreased,but OSDI improved in both groups. The difference was statistically significant（ P〈0. 05）. Compared with 3. 2 mm small incision,t-BUT was better at 1d and 7d,OSDI was lower at 7d,and STI was higher at 7d in 1. 8 mm microincision group. The differences were statistically significant（ P〈0. 05）. Conclusions Coaxial 1. 8 mm microincision phacoemulsification has less impacts on ocular surface and tear film when compared to traditional 3. 2 mm small incision.