白内障合并翼状胬肉联合手术患者术后角膜参数及泪膜稳定性的变化及临床意义的研究

Exploration of Postoperative Corneal Parameters and Stability Changes and Clinical Significance of Tear Film of Patients with Cataract Combined with Pterygium Surgery

目的探讨白内障合并翼状胬肉联合手术患者术后角膜参数及泪膜稳定性的变化及临床意义。方法选取2022年1—12月平南县爱尔眼科医院收治的300例白内障合并翼状胬肉患者,回顾性分析研究其临床诊疗资料,分为对照组与观察组,每组150例。对照组实施分期手术,观察组实施联合手术,对照分析两组视力恢复情况、角膜Pentacam参数、角膜散光度、角膜曲率以及泪膜稳定性变化情况,对人工晶状体(IOL)度数差异进行计算。结果观察组术后裸眼视力、最佳矫正视力均高于对照组,组间差异有统计学意义(P<0.05)。角膜前表面散光、角膜前后表面散光轴位、表面变异系数、前房角以及角膜散光均低于对照组;角膜屈光度均值、角膜前表面屈光度均值、角膜曲率均高于对照组,组间差异有统计学意义(P<0.05)。与对照组(分期手术)相比,观察组(联合手术)术后角膜荧光素染色评分更低,组间差异有统计学意义。观察组人工晶状体度数高于对照组,组间差异有统计学意义(P<0.05),人工晶状体度数偏差范围在-5.6D~+3.5D。结论在白内障合并翼状胬肉临床治疗环节中采取联合手术方式可最大化提升患者视力、泪膜平稳度,对于翼状胬肉切除手术治疗干预后联合采取对侧眼角膜屈光力观察、计算人工晶状体度数,等待角膜屈光力处于稳定状态后,再联合开展白内障超声乳化手术治疗,可优化预后。

Objective To explore and analyze postoperative changes in corneal parameters,tear film stability,and clinical intervention significance of combined surgery in clinical treatment of patients with cataract combined with pterygium.Methods The paper reviewed and analyzed between clinical diagnosis and treatment data of 300 patients with cataracts and pterygium admitted to Pingnan County Aier Ophthalmology Hospital during one-year period(sample inclusion time:from January 2022 to December 2022),and divided them into control group and observation group,with 150 cases in each group.The former was treated with staged surgery,while the latter with combined surgery.Visual recovery,corneal Pentacam parameters,corneal astigmatism,corneal curvature,and tear film stability were compared and analyzed between two groups,and difference in intraocular lens(IOL)degree was calculated.Results Naked eye visual acuity and best corrected visual acuity of observation group after surgery was higher than control group(P<0.05).The astigmatism on anterior surface of cornea,axial position of astigmatism,surface variation coefficient,anterior chamber angle,and corneal astigmatism before and after cornea was lower than control group.Mean corneal refractive index,mean corneal anterior surface refractive index,and corneal curvature was higher than control group(P<0.05).Observation group(combined surgery)had lower corneal fluorescence staining scores after surgery than control group(staged surgery),(P<0.05).Degree of artificial lens in observation group was higher than control group(P<0.05),deviation range of artificial lens degree was between-5.6D and+3.5D.Conclusion During clinical treatment of cataract combined with pterygium,combined surgery can maximize improvement of vision and tear film stability,there is some certain risk of corneal astigmatism.After intervention of pterygium resection surgery,combined observation of contralateral corneal membrane refractive power,calculation of intraocular lens degree can optimize prognosis after corneal refractive power being stable based on combined cataract phacoemulsification surgery.