0.3%玻璃酸钠滴眼液对白内障联合微创玻璃体切除术后眼表的影响

Effect of 0.3%Sodium Hyaluronate Eye Drops on Ocular Surface after Cataract Combined with Minimally Invasive Vitrectomy

目的探讨白内障联合微创玻璃体切除术后连续滴用0.3%玻璃酸钠滴眼液眼表的变化。方法方便选取2020年12月—2021年7月在南京医科大学第一附属医院行白内障超声乳化吸除联合微创玻璃体切除手术的患者50例(50眼),随机分为两组,对照组25例(25眼)术后常规滴眼液治疗,研究组25例(25眼)术后增加使用1个月0.3%玻璃酸钠滴眼液。分析两组患者术前3 d、术后1周、术后1个月中国干眼问卷量表评分、荧光素染色泪膜破裂时间(FBUT)、角膜荧光素染色(FL)、泪液分泌试验(SIt)、睑板腺评分的变化。结果术后1周和术后1个月,研究组的干眼问卷评分为(15.06±6.09)分、(10.34±3.79)分,显著低于对照组(19.79±6.71)分、(12.72±4.08)分,差异有统计学意义(t=2.610、2.137,P<0.05);研究组FBUT为(9.83±0.63)、(11.75±0.67)s高于对照组(5.13±0.79)、(9.06±0.48)s,研究组FL为(1.69±0.53)分、(0.71±0.22)分低于对照组(2.87±0.45)分、(0.93±0.48)分,差异有统计学意义(P<0.05);SIt和睑板腺评分差异无统计学意义(P>0.05)。结论白内障联合微创玻璃体切除手术会降低泪膜稳定性、损伤角膜上皮、增加干眼不适;术后滴用0.3%玻璃酸钠滴眼液可以促进泪膜稳定和角膜上皮修复,从而修复眼表,改善干眼症状。

Objective To investigate the changes of ocular surface after continuous instillation of 0.3%sodium hyaluronate eye drops after cataract combined with minimally invasive vitrectomy.Methods From December 2020 to July 2021,50 patients(50 eyes)who underwent phacoemulsification combined with minimally invasive vitrectomy in the First Affiliated Hospital of Nanjing Medical University were conveniently selected and randomly divided into two groups.25 cases in the control group(25 eyes)were treated with conventional eye drops after surgery,and 25 cases in the study group(25 eyes)were treated with 0.3%sodium hyaluronate eye drops for one month after the operation.The scores of the Chinese Dry Eye Questionnaire were analyzed 3 dbefore operation,1 week after operation,and 1 month after operation,fluorescein staining tear film breaking time(FBUT),corneal fluorescein staining(FL),tear secretion test(SIt),changes in meibomian gland score.Results One week after operation and one month after operation,the dry eye questionnaire scores of the study group were(15.06±6.09)points and(10.34±3.79)points,which were significantly lower than those of the control group(19.79±6.71)points and(12.72±4.08)points,the difference was statistically significant(t=2.610,2.137,P<0.05);the FBUT of the study group was(9.83±0.63)s,(11.75±0.67)s higher than the control group(5.13±0.79)s,(9.06±0.48)s,the FL scores of the study group were(1.69±0.53)points and(0.71±0.22)points lower than those of the control group(2.87±0.45)points and(0.93±0.48)points,the difference was statistically significant(P<0.05).There was no statistically significant difference in the scores of SIt and Meibomian glands(P>0.05).Conclusion Cataract combined with minimally invasive vitrectomy can reduce tear film stability,damage corneal epithelium,and increase dry eye discomfort;postoperative instillation of 0.3%sodium hyaluronate eye drops can promote tear film stability and corneal epithelial repair,thereby repairing the ocular surface,improve the symptoms of dry eye.