摘要
背景白内障手术诱发干眼的发病机制除切口对角膜神经纤维的影响外，可能还与手术改变角膜的规则性有关。目的探讨手法小切口白内障摘出术与超声乳化白内障摘出术后角膜前表面规则性改变及泪膜和角膜散光的动态变化。方法采用前瞻性非随机病例对照研究设计。收集46例50眼年龄相关性白内障患者，其中30例30眼行小切口白内障摘出术，16例20眼行超声乳化白内障摘出术。于术前及术后1d、1周、1个月行角膜地形图检查，测量角膜不规则指数（CIM）、形状系数（SF）和散光值，对患者主观感觉进行评分，于术前及术后1周、1个月测量泪膜稳定性值、泪膜破裂时间（BUT）与基础泪液分泌试验I（SIt）值；分别行各组内、两组间参数比较。结果两组术眼CIM值随着手术前后时间的不同发生变化，术后CIM值均明显高于手术前，总体比较差异有统计学意义（F时间=22．864，P=0．000），其中术后1d、1周、1个月两组术眼CIM值明显高于术前，差异均有统计学意义（P〈0．01）；不同时间点两组间术眼CIM值比较差异无统计学意义（F分组=0．062，P=0．804）。两组术前及术后不同时间点、两组间sF比较差异均无统计学意义（F时间=4．600，P=0．428；F分组=0．009，P=0．925）。两组术眼随着术后时间的延长，BUT值逐渐降低，差异有统计学意义（F时间=39．384，P：0．000），术后1周、1个月各组BUT值较术前降低，差异均有统计学意义（均P=0．000），但各时间点两组间术眼BUT值的比较差异无统计学意义（F分组=0．000，P=0．983）。小切口组术眼手术后1周、1个月SI t值与术前比较差异均有统计学意义（P〈0．01）。两组术后1d、1周、1个月均存在手术源性散光（SIA），但随时间的推移，两组SIA值逐渐减小，差异有统计学意义（F时间=21．479，P=0．000），不同时间点两组间的SIA�
Background Cataract surgery can induce the occurrence of dry eye because of the influence of incision on corneal nerve fibers and the change of corneal regularity derived by surgery. Objective This study was to investigate the change of regularity of anterior corneal surface, tear film and astigmatism caused by the process of manual small-incision cataract surgery （manual SIC S） and phacoemulsification （Phaco）. Methods A prospective non-randomized controlled study was designed. Fifty eyes of 46 age-related cataract patients were included in this clinical study. Thirty eyes of 30 patients received the manual SICS,and other 20 eyes of 16 patients underwent Phaco. Corneal irregularity measurement （CIM） , shape factor （SF） and corneal astigmatism were assessed by the corneal tomography examination,the subjective symptoms were scored and tear film break up time （BUT） , Schirmer I test （S I t） were examined before surgery and 1 day, 1 week, 1 month after surgery. The examined parameters were compared among different time points and two groups. This study was approved by Ethic Committee of Affiliated Eye Hospital of Wenzhou Medical College,and written informed consent was obtained prior to operation. Results The CIM values were gradually increased with the prolong of time after operation, showing a statistically significant difference dependent on time （ Ftime = 22. 864, P = 0. 000） , and CIM value of 1 day, 1 week and 1 month after operation was higher than that of before operation （P〈0. 01 ）. However, no significant difference was found in CIM value between two groups in different time points （ Fgroup = 0. 062, P=0. 804）. There was no significant difference in SF values with time prolong （ Ftime = 4. 600, P = 0. 428 ） and different groups （ Fgroup = 0. 009, P = 0. 925 ）. The BUTwas gradually reduced with the time prolongs with the considerably difference （ Fteim, = 39. 384,P = 0. 000）. Obviously decreases of BUT values were seen in 1 week and 1 month in comparison with
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2013年第4期381-385,共5页
Chinese Journal Of Experimental Ophthalmology
关键词
小切口白内障摘出术
超声乳化白内障摘出术
角膜前表面规则性
手术源性散光
Manual small incision cataract surgery
Phacoemulsification cataract surgery
Regularity ofanterior corneal surface
Surgery-associated astigmatism
