超声乳化白内障摘除联合23G玻璃体切除术对泪膜稳定性的影响

Effect of phacoemulsification cataract extraction combined with 23G vitrectomy on the stability of tear film

目的研究超声乳化白内障摘除联合23G玻璃体切除术对泪膜稳定性的影响。方法纳入2017~2019年我院眼科收治的老年玻璃体视网膜疾病病人120例(120眼),按照手术方式分为对照组和观察组对照组行23G玻璃体切除术(60例60眼),观察组行超声乳化白内障摘除联合23G玻璃体切除术(60例60眼)。分别于术前,术后7、30、90 d对2组病人进行基础泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色(CFS)检查。结果2组病人术前泪液分泌值、CFS评分及BUT差异均无统计学意义(P>0.05)。与术前相比,2组病人术后7、30 d BUT缩短(P<0.05),术后7 d CFS评分及泪液分泌增加(P<0.05),且观察组上述指标变化幅度均大于对照组(P<0.05)。术后90 d,2组泪液分泌值、CFS评分及BUT差异均无统计学意义,且均恢复至术前水平(P>0.05)。结论超声乳化白内障摘除联合23G玻璃体切除术在术后7 d短期内对泪膜稳定性的影响程度大于单纯玻璃体切割手术,术后90 d相关指标可恢复至术前水平。

Objective To observe the effect of phacoemulsification cataract extraction combined with 23G vitrectomy on the stability of the tear film.Methods A total of 120 patients with vitreoretinal disease in our hospital from 2017 to 2019 were enrolled,and they were divided into two groups according to the surgical method 60 patients(60 eyes)were treated with 23G vitrectomy(control group)and 60 patients(60 eyes)were treated with phacoemulsification cataract extraction combined with 23G vitrectomy(observation group).All the patients were examined by the Schirmer I test(SⅠt),break-up time(BUT)and cornea fluorescein staining(CFS)before operation,7 days,30 days and 90 days after operation.Results There were no statistical differences in the preoperatively examination results of SⅠt,BUT or CFS between the two groups(P>0.05).The BUT of both groups was shortened significantly 7 days and 30 days after operation(P<0.05),the score of CFS and the value of tear secretion in both groups were significantly increased 7 days after operation(P<0.05),and the changes of the above indexes in the observation group were more significant than those in the control group(P<0.05).90 days after operation,there was no significant difference in the value of tear secretion,CFS score and BUT between the two groups(P>0.05),and they all recovered to the preoperative level.Conclusions Compared with vitrectomy,the effect of phacoemulsification cataract extraction combined with 23G vitrectomy on tear film stability 7 days after operation is more obvious,and the related indexes can recover to the preoperative level in 90 days after operation.