玻璃酸钠滴眼液、聚丙烯酸眼胶治疗对白内障超声乳化术后干眼症患者眼膜稳定性、眼液基础分泌量的影响

Effects of polyacrylic acid eye gel and sodium hyaluronate eye drops on tear film stability and basal secretion of ocular humor in patients with xerophthalmia after phacoemulsification

目的探讨玻璃酸钠滴眼液、聚丙烯酸眼胶治疗对白内障超声乳化术后干眼症患者眼膜稳定性、眼液基础分泌量的影响。方法选取行白内障超声乳化术且术后出现干眼症的患者134例,回顾临床资料,根据医嘱制定的干预方案的差异,分为对照组(n=39)、聚丙烯酸组(n=43)和玻璃酸钠组(n=52),对照组予常规治疗,聚丙烯酸组和玻璃酸钠组在此基础上分别加用聚丙烯酸眼胶、玻璃酸钠滴眼液治疗,对比三组患者术后7天、14天、3周、1个月的主观干燥异物感(subjective drying foreign body sensation,DES)、泪液分泌试验(schirmer test,SIt)、泪膜破裂时间(tear film rupture time,BUT)、角膜荧光素染色评分(corneal fluorescein staining,CFS)变化。结果治疗前三组DES分值比较差异无统计学意义(P>0.05);术后7天、14天、3周、1个月,三组DES分值均逐渐下降(P<0.01),玻璃酸钠组DES分值最低(P<0.01)。治疗前三组SIt比较差异无统计学意义(P>0.05);术后7天、14天、3个周、1个月,三组SIt均逐渐升高(P<0.01),玻璃酸钠组SIt最高(P<0.01)。治疗前三组泪膜不稳定比率比较差异无统计学意义(P>0.05);术后7天、14天、3周、1个月,三组泪膜不稳定比率逐渐降低,玻璃酸钠组最低(P<0.05)。治疗前三组CFS评分比较差异无统计学意义(P>0.05);术后7天、14天、3周、1个月,三组CFS评分均逐渐下降(P<0.01),玻璃酸钠组CFS评分最低(P<0.05)。134例患者治疗期间均未出现明显的不良反应。结论常规治疗联合人工泪液玻璃酸钠滴眼液、聚丙烯酸眼胶治疗可有效改善白内障超声乳化术后干眼症患者的泪膜稳定性,增加眼液基础分泌量,缓解患者临床症状,玻璃酸钠滴眼液优于聚丙烯酸眼胶。

Objective To investigate the effects of sodium hyaluronate eye drops and polyacrylic acid eye gel on tear film stability and basal secretion of ocular humor in patients with xerophthalmia after phacoemulsification.Methods 134 patients with postoperative xerophthalmia after phacoemulsification admitted to hospital were selected.Their clinical data were analyzed retrospectively.According to intervention plans formulated by doctors,they were divided into control group(n=39),polyacrylic acid group(n=43)and sodium hyaluronate group(n=52).The control group were given conventional treatment,the polyacrylic acid group and the sodium hyaluronate group were treated with polyacrylic acid eye gel and sodium hyaluronate eye drops,respectively.And then,subjective drying foreign body sensation(DES),schirmer test(SIt),tear film rupture time(BUT)and the change of corneal fluorescein staining(CFS)at 7 days,14 days,3 weeks,and 1 month after surgery were compared in the three groups of patients.Results Before treatment,there was no statistically significant difference in DES scores among the three groups(P>0.05).After 7 days,14 days,3 weeks and 1 month of surgery,the DES scores of the three groups decreased gradually(P<0.01),and that of the sodium hyaluronate group was the lowest(P<0.01).Before treatment,there was no statistically significant difference in SIt between the three groups(P>0.05).After 7 days,14 days,3 weeks and 1 month of surgery,the SIt of the three groups increased gradually(P<0.01),and that of the sodium hyaluronate group was the highest(P<0.01).Before treatment,there was no statistically significant difference in the rate of tear film instability among the three groups(P>0.05).After 7 days,14 days,3 weeks and 1 month of surgery,the tear film instability rates decreased gradually in the three groups,and that of the sodium hyaluronate group was the lowest(P<0.05).Before treatment,there was no statistically significant difference in CFS scores among the three groups before treatment(P>0.05).After 7 days,14 days,3 weeks and 1 month of surgery,the CFS scores of the three groups decreased gradually(P<0.01),and that of the sodium hyaluronate group was the lowest(P<0.05).No obvious adverse reactions were found among 134 patients during treatment.Conclusion Routine treatment combined with artificial tears such as polyacrylic acid eye gel and sodium hyaluronate eye drops can effectively improve the tear film stability of xerophthalmia patients after phacoemulsification,increase the basic secretion of eye fluid and alleviate the clinical symptoms of patients,and sodium hyaluronate eye drops are superior to polyacrylic acid eye gels.