超声乳化术改良角膜切口对术后泪膜的影响

The effect of improved corneal incision in phacoemulsification on tear film

目的观察晶状体超声乳化术改良透明角膜切口对术后泪膜的影响。方法2014年7月至2015年6月晶状体超声乳化手术60例（60眼）。随机分为两组，观察组采用改良（经结膜）的透明角膜切口超声乳化术30例（30眼），对照组采用常规透明角膜切口超声乳化术30例（30眼）。观察术前3d及术后1d、2周、1个月、3个月泪膜破裂时间（BUT）、基础泪液分泌试验（SIt）、角膜荧光素染色（FL）评分，分析两种切口对术后泪膜功能的影响。结果术后1d,2周、1个月，两组的泪液分泌量增加，观察组的泪液分泌量明显多于对照组，差异有统计学意义（P〈0．05）。观察组与对照组相比BUT延长、FL减轻，差异有统计学意义（P〈0．05）。术后3个月两组BUT、SIt、FL与术前相比，差异均无统计学意义（P〉0．05）。结论与常规的透明角膜切口相比，改良透明角膜切口超声乳化术对泪膜影响较小。

Objective To observe the effect of improved corneal incision in phacoemulsification on tear film. Methods Sixty eyes of 60 cases with age related cataract from July 2014 to June 2015 underwent phacoemulsification. They were randomly divided into 2 groups. In observation group, 30 eyes of 30 patients received phacoemulsification via improved corneal incision through the conjunctiva. While in control group, 30 eyes of 30 patients underwent phacoemulsification via conventional corneal incision. Breakup time of tear film （BUT）, Schirmer I test （S I t） and corneal fluorescence staining （FL） were observed and compared at 3 days before surgery and 1 day, 1 week, 1 month, 3 months after surgery. The effect of two kinds of incisions on the tear film function after operation was statistically analysed. Results One day, 2 weeks and 1 month after surgery, the tear secretion had increased in two groups, the observation group of tear secretion was higher than that of control group. The difference were statistically significant （ P 〈 0.05 ）. Corneal fluorescence staining in control group was obviously increased and BUT was greatly shortened, the difference was statistically significant （P 〈 0.05）. The difference in BUT, S I t and FL at 3 months after surgery was not statistically siginificant between the two groups （ P 〉 0.05 ）. Conclusion Improved transparent corneal incision in phacoemulsification has lesser effect on the tear film than conventional corneal incision.