白内障超声乳化摘除术对睑板腺形态和功能的影响

Effect of phacoemulsification on morphology and function of meibomian gland

目的评估白内障超声乳化摘除术后早期患者睑板腺形态和功能的改变。方法选取行白内障超声乳化摘除联合人工晶状体植入术的年龄相关性白内障患者53例(53眼)进行前瞻性自身对照研究,分别于术前、术后1周、术后1个月进行眼表疾病指数(OSDI)问卷评分、睑缘形态评估、睑板腺缺失率测量、泪膜脂质层厚度测量、泪膜破裂时间评估。结果白内障超声乳化摘除术后1周、术后1个月的OSDI问卷评分、睑缘形态评分较术前显著升高(P<0.05),术后1周、术后1个月泪膜脂质层厚度和泪膜破裂时间较术前显著减小/缩短(P<0.05),而术后1周和术后1个月睑板腺缺失率较术前无明显改变(P>0.05)。结论白内障超声乳化摘除术后早期患者会出现睑板腺形态改变及功能下降,而睑板腺功能下降与睑板腺数量无关。

Objective To evaluate the early changes of morphology and function in meibomian gland of patients after phacoemulsification.Methods A total of 53 patients(53 eyes)with age-related cataract who underwent phacoemulsification combined with intraocular lens implantation were selected for perspective self-controlled study.The score of Ocular Surface Disease Index(OSDI)questionnaire,the evaluation of palpebral margin morphology,the measurement of deficiency rate of meibomian gland,the measurement of tear film lipid layer thickness,and the evaluation of tear film break-up time were conducted before operation,1 week after operation and 1 month after operation,respectively.Results The scores of OSDI questionnaire and palpebral margin morphology 1 week and 1 month after phacoemulsification were significantly increased compared with those before operation(P<0.05).The tear film lipid layer thicknesses and tear film break-up time 1 week and 1 month after operation were significantly decreased/shortened compared with those before operation(P<0.05),while the deficiency rates of meibomian gland 1 week and 1 month after operation were not significantly changed compared with those before operation(P>0.05).Conclusion Morphological changes and function decline of meibomian gland will occur in the early stage of patients after phacoemulsification,while the decline of meibomian gland function is not related to the number of meibomian glands.