不同术式白内障超声乳化和人工晶体植入术联合对术后干眼症泪膜破裂时间、泪液分泌量及症状评分的影响

Effects of Different Surgical Cataract Phacoemulsification and Intraocular Lens Implantation on the Tear Film Rupture Time,Tear Secretion and Symptom Score of Postoperative Dry Eye

目的:观察在人工晶体植入术基础上联合不同白内障超声乳化术式对患者术后干眼的泪膜破裂、泪液分泌量等影响。方法:选取2016年5月-2017年5月在笔者所在医院行白内障超声乳化、人工晶体植入术联合治疗的76例白内障患者,按术式不同分两组,每组38例,两组均行人工晶体植入术,对照组白内障超声乳化作透明角膜切口术式,观察组白内障超声乳化作巩膜隧道切口术式,比较组间泪膜破裂时间、泪液分泌量及症状评分。结果:观察组术后1周、1个月及3个月泪膜破裂时间(6.87±5.25)s、(7.88±1.35)s及(9.77±5.12)s,比对照组长(P<0.05);观察组术后1周、1个月及3个月的泪液分泌量(11.87±4.74)mm/5 min、(11.45±6.35)mm/5 min及(12.38±5.66)mm/5 min,均比对照组多(P<0.05);观察组术后1周、1个月及3个月干眼症状评分均对照组低(P<0.05)。结论:白内障患者在人工晶体植入术基础作巩膜隧道切口行白内障超声乳化治疗,显著减小术后干眼症发生率。

Objective ： To observe the effects of intraocular lens implantation combined with phacoemulsification of differen.t types of cataract on the tear film rupture and tear secretion of patients after dry eye surgery.Method： Seventy-six patients with cataract who underwent cataract phacoemulsification and intraocular lens implantation in our hospital from May 2016 to May 2017 were selected and divided into two groups according to different surgical methods.There were 38 cases in each group.IOL implantation was performed in the control group.The phacoemulsification of the cataract was performed as a transparent corneal incision in the control group.The phacoemulsification of the cataract in the observation group was performed as a scleral tunnel incision and the tear film rupture time, tear secretion, and symptom score were compared between the groups.Result： The tear film rupture time was （6.87 ± 5.25）s, （7.88 ± 1.35）s and （9.77 ± 5.12）s in the observation group at 1 week, 1 month and 3 months after surgery, which were longer than those of the control group（P〈0.05）.The tear secretion of the observation group at 1 week, 1 month and 3 months after operation （11.87± 4.74）mm/5 min, （11.45 ± 6.35）mm/5 rain, and （12.38 ± 5.66）mm/5 min, both more than the control group（P〈0.05）, the observation group 1 week, 1 month and 3 months dry eye symptoms scores were lower in the control group（P〈0.05）.Conclusion： Cataract patients undergoing phacoemulsifieation with scleral tunnel incision on the basis of intraocular lens implantation significantly reduce the incidence of postoperative dry eye.