不同年龄白内障患者超声乳化术后干眼的临床分析

Clinical analysis of dry eyes after phacoemulsification in cataract patients of different ages

目的探讨不同年龄白内障患者行白内障超声乳化手术后干眼相关指标的变化。方法选择2016年7月至2018年6月于北京丰台医院就诊的白内障患者105例(3~4级核,105眼),根据年龄分为A、B、C组(A组51~60岁,B组61~70岁,C组71~80岁),每组35例。3组患者均行12点位3 mm角膜缘切口的白内障超声乳化及人工晶状体植入术。分别于白内障手术前1周,术后1周、1个月、3个月行干眼症状评分、基础泪液分泌试验Ⅰ(Schirmer I test,SIT)、泪膜破裂时间(tear break-up time,BUT)、角膜荧光素染色检查。结果术后1周,C组干眼症状评分为2.0(1.0,2.0)分、SIT值为10.0(9.0,11.0)分,显著低于A组、B组(P均<0.05);C组的BUT值为8.0(6.5,10.0)分,显著低于A组(P<0.05);C组角膜染色积分为2(1,2)分,显著高于A组、B组(P<0.05)。术后1个月,C组BUT值9.0(8.0,10.0)分,显著低于A组、B组(P均<0.05);C组角膜染色积分为1(1,2)分,显著高于A组、B组(P均<0.05)。结论70岁以上患者在白内障术后早期干眼体征显著加重,然而其主观症状较轻。

Objective To investigate the differences of dry eye index in the cataract patients with different ages after phacoemulsification.Methods Retrospective cross-sectional study was selected,105 cases of cataract patients(grade 3-4 nucleus,105 eyes)admitted to Beijing Fengtai Hospital,from July 2016 to June 2018 were enrolled and randomly divided into group A,B and C according to different ages(group A:51-60 years old;group B:61-70 years old;group C:71-80 years old),35 patients in each group.Phacoemulsification and intraocular lens implantation were performed through a 12-point 3 mm corneal limbal incision in all three groups.Dry eye symptom score,basic tear secretion test I(Schirmer I test,SIT),tear break-up time(BUT),and corneal fluorescein staining were performed one week before cataract surgery,one week,one month and three months after surgery,respectively.Results One week after surgery,the dry eye symptom scores[2.0(1.0,2.0)],and SIT values[10.0(9.0,11.0)mm]in group C were less than those in group A and group B(P<0.05);BUT value[8.0(6.5,10.0)s]was less than that in group A(P<0.05);the corneal staining scores[2(1,2)]was more than that in group A and group B(P<0.05).One month after surgery,BUT values[9(8,10)s]in group C were less than those in group A and group B(P<0.05);the corneal staining score[1(1,2)]was more than that in group A and group B(P<0.05).Conclusions The dry eye signs of the patients over 70 years old significantly aggravate after cataract surgery,but the subjective symptoms are mild.