孟逸芳



·临床报告·

超声乳化术不同切口对白内障患者泪膜稳定性的影响

孟逸芳

Department of Ophthalmology, Changshu No.2 People’s Hospital, Changshu 215500, Jiangsu Province, China

•METHODS: From January 2014 to September 2015, 108 patients (144 eyes) who underwent cataract surgery were divided into two groups: group A with clear corneal incision (52 cases with 74 eyes), group B with scleral tunnel incision (56 cases with 70 eye). Two groups of patients were taken the same incision width. Symptoms of dry eye and tear film break-up time (BUT) were observed 1d before and 1d, 1, 3wk, 1 and 3mo postoperatively.

•RESULTS: After performing cataract phacoemulsification 1d, 1wk, symptoms score of dry eye of group A was less than that of group B, the difference was statistically significant (t=-6.199, -2.871,P<0.01), while at other times after operation there were no significant differences (t=-1.639, -0.829, -0.301,P>0.05); at postoperative 1d, 1 and 3wk, BUT of group B was better than those of group A, there were a statistically significant differences (t=-3.718, -2.342, -2.506,P<0.05), there were no significant differences at other the time after operation (t=-0.882,1.225,P>0.05).

•CONCLUSION: The difference on effect of two different incision on the tear film stability only last a short time, which disappeared at 1mo after operation. The clear corneal incision has stronger impacts on tear film stability than scleral tunnel incision, while with a lower score on symptoms of dry eye.

目的：观察超声乳化手术不同切口对白内障患者泪膜稳定性的影响。

方法：随机抽取2014-01/2015-09我院行白内障超声乳化手术的患者108例144眼，分成两组：A组行透明角膜切口(52例74眼)；B组行巩膜隧道切口(56例70眼)。两组患者保持相同的切口宽度。观察手术前1d，手术后1d，1、3wk，1、3mo眼部情况，记录患者干眼症状和泪膜破裂时间(break-up time，BUT)。

结果：白内障患者在进行超声乳化手术后1d、1wk，A组干眼症状评分要小于B组，差异有显著统计学意义(t=-6.199、-2.871，P<0.01)，而在术后其它时间则无统计学差异(t=-1.639、-0.829、-0.301，P>0.05)；术后1d、术后1wk、术后3wk B组的BUT较A组长，对比有统计学差异(t=-3.718、-2.342、-2.506，P<0.05)，术后其他时间则无统计学差异(t=-0.882、1.225，P>0.05)。

结论：白内障超声乳化手术的两种不同切口对泪膜稳定性的影响仅在术后短期内存在差异；而术后1mo后无明显差异。另外行透明角膜切口对泪膜稳定性的影响要大于行巩膜隧道切口，但干眼症状评分要明显小于行巩膜隧道切口。

白内障；超声乳化术；泪膜稳定性

引用：孟逸芳.超声乳化术不同切口对白内障患者泪膜稳定性的影响.国际眼科杂志2016;16(7):1375-1377

0引言

据不完全统计，我国白内障患者多达700多万，并且以每年45万人的速度迅猛增长。一些白内障患者为改善视力[1]，往往选择手术治疗，超声乳化手术具有对患眼创伤小、恢复快等优点，然而超声乳化手术在不同程度上留下了一些后遗症[2]，比如术后短期内患眼出现异物感、干涩感及看东西模糊感，同时伴随着泪膜脆弱、易破裂等现象[3]。因此本研究随机选取入院行超声乳化手术患者108例144眼，通过采用不同手术切口(透明角膜切口、巩膜隧道切口)观察对患者泪膜稳定性的影响，以期望寻找更好的术后护理方法，减少术后不良现象的出现，使此项手术更加优化，给白内障患者带来更多的福音。……