不同人工泪液对白内障超声乳化吸除术后患者干眼症的临床疗效对比分析

Clinical efficacy of different artificial tears for patients with xerophthalmia after phacoemulsification

目的:对比分析不同人工泪液对白内障超声乳化吸除术后干眼症的临床疗效。方法:通过对我院2014-03/2017-04行白内障超声乳化吸除术的年龄相关性白内障患者150例150眼的临床资料进行回顾性分析,根据白内障超声乳化吸除术后辅助泪液的不同分为A组(对照组)、B(应用玻璃酸钠滴眼液)、C组(应用卡波姆凝胶滴眼液)3组(各50例50眼)。比较并分析三组患者术前、术后1wk,1、3mo BUT、FL评分、SⅠt检查结果及OSDI评分和术前、术后3mo Log MAR视力情况。结果:三组患者术前、术后1wk BUT、FL评分、SⅠt检查结果及OSDI评分比较均无差异(P>0.05)。术后1mo,B、C组BUT、SⅠt均高于A组,OSDI、FL评分均低于A组(P<0.05),B组与C组BUT、FL评分、SⅠt及OSDI评分比较均无差异(P>0.05)。术后3mo,B、C组BUT、SⅠt均高于A组,FL及OSDI评分均低于A组(P<0.05),C组BUT、SⅠt均高于B组,FL及OSDI评分均低于B组(P<0.05)。三组患者术后3mo视力均较术前改善(P<0.05)。三组患者术前、术后3mo视力比较均无差异(P>0.05)。结论:白内障超声乳化吸除术辅助不同类型人工泪液治疗年龄相关性白内障,均能在一定程度改善患者干眼症状,其中卡波姆滴眼液或含脂类的人工泪液对于术后干眼症状与体征的改善效果更好,且不会影响视力的恢复。

AIM： To compare and analyze the clinical efficacy of different artificial tears for patients with xerophthalmia after phacoemulsification. METHODS： Retrospective analysis on the clinical data of 150 cases（150 eyes）treated by phacoemulsification in our hospital from March 2014 to April 2017. And according to the artificial tears used, they were divided into Group A（control group）and B（application of sodium hyaluronate eye drops）, Group C（used carbomer gel eye drops）,50 cases 50 eyes in every group. We compared and analyzed the BUT, FL, SⅠt findings, OSDI scores preoperatively and 1wk, 1 and 3mo postoperatively, and visual acuity before and 3mo after operation in the three groups. RESULTS： There were no differences in BUT, FL, SⅠt and OSDI scores between the three groups before and at 1wk after the operation（P〉0.05）. At 1mo after operation, the levels of BUT and SⅠt in Group B and Group C were higher than those in Group A, and the scores of OSDI and FL were lower than those in Group A（P〈0.05）; between Group B and Group C there was no difference in BUT, FL, SⅠt levels and OSDI score（P〉0.05）. After 3mo, the levels of BUT and SⅠt in the Group B and Group C were higher than that in the Group A, and the FL level and OSDI score were lower than those in the Group A（P〈0.05）; the levels of BUT and SⅠt in the Group C were higher than those in the Group B, and the FL level and the OSDI score were lower than those in the Group B（P〈0.05）. The visual acuity of the three groups was improved at 3mo after the operation（P〈0.05）, and there was no difference in LogMAR visual acuity between the three groups before and 3mo after operation（P〉0.05）.CONCLUSION： different types of artificial tear can improve the symptoms of dry eyes in patients age-related cataract after phacoemulsification, in which carbomer eye drops or lipid containing artificial tears improve postoperative dry eye symptoms and signs, and will not affect the recovery of visual acuity.