高浓度玻璃酸钠眼液对老年性白内障术后泪膜功能恢复的临床研究

Clinical Study of High-concentration Sodium Hyaluronate Eye Drops on Recovery of Tear Film Function After Phacoemulsification in Senile Cataract Surgery

目的观察高浓度玻璃酸钠滴眼液对老年性白内障超声乳化术后泪膜恢复的影响。方法选取作者医院老年性白内障超声乳化术的56例(56只眼)患者随机均分成观察组和对照组,每组各28只眼。观察组用玻璃酸钠滴眼液(3 g/L)点眼,对照组用玻璃酸钠滴眼液(1 g/L)点眼,两组术前给予妥布霉素滴眼液点眼,术后均给予典必殊滴眼液点眼,比较两组术前,术后1、7、15 d的泪液分泌试验(schirmer I test,SIt)、泪膜破裂时间(break-up time,BUT)、角膜荧光染色(fluorescein staining,FL)评分及干眼主观症状评分。结果组间比较:治疗前、治疗后30d,两组的泪膜各项指标比较差异均无统计学意义(P>0.05);主观症状评分、BUT水平治疗后1、7和15 d两组比较差异有统计学意义(P<0.05),FL评分治疗后7 d和15 d两组比较差异有统计学意义(P<0.05)。组内比较:观察组治疗后1、7 d主观症状评分、BUT、FL与术前比较,差异有统计学意义(P<0.05),SIt评分治疗后1 d与术前比较,差异有统计学意义(P<0.05);对照组术后1、7、15 d主观症状评分、BUT、FL与治疗前比较,差异均有统计学意义(P<0.05),SIt评分治疗后1 d与治疗前比较,差异具有统计学意义(P<0.05)。结论高浓度玻璃酸钠滴眼液能够在老年性白内障术后较快改善干眼症状,促进泪膜恢复,提高泪膜的稳定性。

Objective To observe the efficacy of high-concentrations of sodium hyaluronate eye drops on the recovery of tear film function after phacoemulcification in senile cataract.Methods Fifty-six eyes of 56 senile cataract patients who received phacoemulsification were collected in authors' hosptial and randomly divided into treatment group and control group(each28 eyes).The observation group was given sodium hyaluronate eye drops(3 g/L),and the control group was treated with sodium hyaluronate eye drops(1 g/L).All two groups were given tobramycin dexamethasone eye drops after surgery.The schirmer I test(Sit),break-up time(BUT),fluorescence staining(FL)score and subjective symptoms scores of dry eyes were compared between two groups before and 1-,7-and 15-day after operation.Results Comparison between groups:there was no significantly difference in the indexes of tear film between the two groups before and30 days after treament(P>0.05).Subjective symptom scores at 1-,7-and 15-day after treatment were significantly different between two groups(P<0.05),and BUT at 7-and 15-day after treatment were significantly differences between two groups(P<0.05).Comparison within the group:subjective symptom scores,BUT and FL scores of the observation group were obviously different at 1-and 7-day after operation compared with pre-operation(P<0.05),and SIt score at post-operative 1 day was significantly different compared with the pre-operation(P<0.05).There were markedly differences in subjective symptom scores,BUT and FL scores of control group between before operation and at 1-,7-,15-day after operation(P<0.05),and the difference was found in SIt scores between before treatment and at 1 day after treatment(P<0.05).Conclusion High concentration of sodium hyaluronate eye drops can improve the symptoms of dry eye faster after senile cataract surgery,promote the recovery of tear film function and increase the stability of tear film.