睑板腺功能障碍患者白内障术后眼表状况

Ocular Surface Status in Meibomian Gland Dysfunction Patients after Cataract Surgery

目的:分析睑板腺功能障碍患者白内障手术后眼表状况的改变。方法:前瞻性研究。收集2015年1月至2017年1月期间就诊于上海市浦东医院眼科并接受白内障超声乳化摘除术联合人工晶状体植入术的睑板腺功能障碍患者67例(83眼),评价术前及术后1、2、3个月的眼表症状指数评分(OSDI)、裂隙灯显微镜下睑缘形态评分、角膜荧光素染色评分(CFS)、泪膜破裂时间(BUT)、基础泪液分泌试验(SⅠT)以及光学相关断层扫描技术计算下泪河高度(TMH)、下泪河深度(TMD)和下泪河面积(TMA)。采用重复测量的方差分析进行统计学处理。结果:术后1、2、3个月的OSDI较术前显著恶化(F=1193.031,P<0.001),BUT显著下降(F=21.042,P<0.001);而睑缘形态评分、CFS、TMH、TMD、TMA和SⅠT在术后没有显著改变。结论:睑板腺功能障碍患者白内障术后在不伴有明显器质性改变的情况下就可能出现眼表症状的进一步加重。

Objective:To analyze the ocular surface status in meibomian gland dysfunction patients after cataract surgery.Methods:This was a prospective study.We studied 83 eyes of67meibomian gland dysfunction patients who were treated in the Ophthalmology Department of Shanghai Pudong Hospital from January 2015 to January 2017 underwent phacoemulsification and intraocular lens implantation were studied and analyzed preoperatively and at1month,2 months and3months postoperatively.Ocular symptom scores,lid margin abnormalities,corneal fluorescein staining(CFS),tear film breakup time(BUT),SchirmerⅠtest(SⅠT),and lower tear meniscus height,depth,and area using Fourier domain optical coherence tomography were measured.Statistical methods are repeated measures of variance analysis.Results:Theocular symptom scores were worse at1month,2 months and 3 months postoperatively(F=1193.031,P<0.001).BUT decreased postoperatively(F=21.042,P<0.001).However,lid margin abnormalities,CFS,lower tear meniscus(height,depth and area)and the SⅠT did not change significantly postoperatively.Conclusions:A worsening of ocular symptoms may occur without accompanying obvious structuralchanges in meibomian gland dysfunction patients after cataract surgery.