白内障超声乳化术两种切口对术后干眼的影响

Effects of two incisions on dry eyes after phacoemulsification for age-related cataract

目的比较年龄相关性白内障超声乳化术两种不同切口对术后干眼的影响。方法前瞻性随机对照研究。纳入武警河北省总队医院2017年1月至2019年12月年龄相关性白内障手术124例(124只眼),按随机数字表法分为两组,巩膜隧道切口者定为观察组(61例),角膜缘切口者定为对照组(63例)。比较两组术后干眼情况。术后随访3个月。结果术前1 d,干眼症状评分、泪膜破裂时间(BUT)、角膜荧光染色(FL)及基础泪液分泌试验(SIt)两组间差异均无统计学意义(均P>0.05)。术后2周及3周两组间干眼症状评分、BUT、FL,观察组优于对照组(2周:t=2.13,4.33,1.44;P=0.012,0.001,0.032;3周:t=2.018,4.52,1.34;P=0.014,0.004,0.036),而SIt两组间差异无统计学意义(2周:t=0.29,P=0.875;3周:t=0.52,P=0.554)。两组术后3个月两组间干眼指标差异均无统计学意义(均P>0.05)。结论年龄相关性白内障患者巩膜隧道切口超声乳化术后2周及3周对干眼的影响较角膜缘切口者轻,两组术后3个月情况均明显好转。

Objective To compare the effects of two incisions on dry eyes after phacoemulsification for age-related cataract.Methods This was a prospective random control study.Total of 124 eyes of 124 patients with age-related cataract in Armed Police Crops Hospital of Hebei from Jan.2017 to Dec.2019 were included.The patients were divided into the observation group and the control group,based on random number table methods.There were 61 patients used scleral tunnel incision in the observation group,while 63 patients used corneal limbus incision in the control group.The postoperative dry eye condition was compared between the two groups.The follow-up time was 3 months after surgery.Results At 1 day before surgery,there were no significant difference in score of dry eye syndrome,tear film break-up time(BUT),corneal fluorescence staining(FL)and Schirmer I test(SIt)between the two groups(all P>0.05).At 2 and 3 weeks after surgery,the scores of dry eye syndrome,BUT and FL in observation group were better than those in control group(2 weeks:t=2.13,4.33,1.44;P=0.012,0.001,0.032;3 weeks:t=2.018,4.52,1.34;P=0.014,0.004,0.036).But no obvious difference in SIt between the two groups(2 weeks:t=0.29,P=0.875;3 weeks:t=0.52,P=0.554).The difference of all parameters of dry eye between the two groups at 3 months after surgery were not statistically significant.Conclusion The scleral tunnel incision is with lighter effect on dry eye than the corneal limbus incision at 2 and 3 weeks after phacoemulsification for age-related cataract.The dry eye condition of the two groups improve significantly at 3 months after surgery.