那曲地区与沈阳市白内障患者超声乳化术后泪膜变化比较研究

Comparison of tear film function of cataract patients after phacoemulsification in Nagqu Prefecture and Shenyang

目的探讨那曲与沈阳市两地白内障患者超声乳化手术前后泪膜的变化。方法临床病例对照研究。选取于中国医科大学眼科医院于2016年1-2月接受手术的年龄相关性白内障患者30例（30只眼），及那曲地区人民医院于2015年11-12月接受手术的年龄相关性白内障患者30例（30只眼），所有患者均于术前以及术后1d、1周、1个月、3个月接受Schiemer试验、泪膜破裂时间检查和患者主观干眼感觉评分调查。结果沈阳市患者术后Schiemer值显著升高（P〈0．05），1周时恢复到术前水平，术后BUT显著缩短（P〈0．05），1个月时恢复到术前水平，术后患者主观干眼感觉评分显著升高（P〈0．05），1个月时恢复到术前水平。那曲地区患者术后Schiemer值显著升高（P〈0．05），1周时恢复到术前水平，术后BUT显著缩短（P〈0．05），3个月时恢复到术前水平，患者主观干眼感觉评分在手术前后无明显变化（P〉0．05）。结论白内障超声乳化手术会造成术后泪膜稳定性的下降，相较于低海拔地区，高海拔地区白内障患者术前泪膜稳定性差，术后恢复也较慢。

Objective To investigate the changes of tear film in cataract patients after phaco- emulsification in Nagqu Prefecture and Shenyang. Methods Thirty patients （30 eyes） with aged-relat- ed cataract in Shenyang and 30 patients （30 eyes） with aged-related cataract in Nagqu Prefecture who underwent phacoemulsification through clear corneal incison were selected. Schirrner test, tear breakup time and subjective score for dryness were measured preoperatively, were also measured at postoperative 1 day, 1 week, 1 month and 3 months. Results In Shenyang group, Schirmer test val- ue increased significantly （P 〈0.05） after the operation and returned to preoperative level at postoper- ative 1 week. Tear breakup time reduced significantly （P 〈0.05） after the operation and returned to preoperative level at postoperative 1 month. Subjective score for dryness increased significantly （P 〈 0.05） after the operation and returned to preoperative level at postoperative 1 month. In Nagqu group, Schirmer test value increased significantly （P 〈0.05） after the operation and returned to preop- erative level at postoperative 1 week. Tear breakup time reduced significantly （P 〈0.05） after the op- eration and returned to preoperative level at postoperative 3 months. There was no significant change of subjective score for dryness （P 〉0.05） between preoperative value and any postoperative value. Conclusions Tear film stability significantly decreases after phacoemulsification. Comparing with lower altitudes, tear film stability of cataract patients in higher altitudes gets worse before the operation and recovers more slowly after the operation.