硬核白内障小切口手法娩核术后眼表和泪膜变化的对比分析

Comparative analysis on the changes of ocular surface and tear film after small incision manual nucleus delivery for cataract with hard nucleus

目的比较小切口手法娩核术与超声乳化术对硬核白内障眼表及泪膜的影响。 方法回顾性分析硬核白内障60例（60眼）的临床资料。患者随机分为小切口组和超乳组，每组各30例（30眼）。小切口组行小切口手法白内障摘出术，超乳组行超声乳化术。术后随访3个月。 结果两组患者术后1周和1个月的泪河高度和BUT均低于术前（P〈0.05）,角膜荧光素染色和问卷评分均高于术前（P〈0.05）；两组患者术后1周SIt均高于术前（P〈0.05）。术后1周小切口组角膜荧光素染色、SIt和问卷评分均明显高于超乳组（P〈0.05）。 结论硬核白内障术后早期小切口手法娩核手术对眼表及泪膜的影响较大，但术后晚期与超声乳化术无差异。

ObjectiveTo compare the effect of small incision manual nucleus delivery and phacoemulsification on ocular surface and tear film for patients with hard nucleus cataract. MethodsThe clinical data of 60 eyes of 60 patients with hard nucleus cataract were analyzed retrospectively. All patients were randomly divided into small incision group and phacoemulsification group with 30 eyes of 30 cases in each group. The small incision group underwent cataract extraction with small incision manual nucleus delivery. The followed-up time was 3 months. ResultsThe tear river height（TMH） and tear break-up time（BUT） in 1 week and 1 month after surgery were lower than those before surgery （all P〈0.05）. The corneal fluorescein staining（FS） and questionnaire score were increased in 1 week and 1 month after surgery （P〈0.05）. The Schirmer I test（SIt） were increased in 1 week after surgery （P〈0.05）. The score of corneal FS, SIt and questionnaire score in small incision group was significantly higher than those in phacoemulsification group in 1 week after surgery（P〈0.05）. ConclusionThere is great effect of small incision manual nucleus delivery for hard nucleus cataract on ocular surface and tear film at the early stage after surgery, but there is no difference of effect at late stage compared with phacoemulsification.