摘要
目的:探讨白内障超声乳化手术中不同尺寸透明角膜切口对术后泪液功能的影响。方法:收集2012年11月至2013年5月在温州医科大学附属眼视光医院行超声乳化手术治疗白内障患者60例(60眼),按照随机数字表分成2组:A组(30眼)行常规3.0 mm透明角膜切口白内障超声乳化术,B组(30眼)行1.8 mm透明角膜微切口白内障超声乳化术。2组术前和术后1 d、1周、1个月及3个月行干眼主观症状评分(DES),光学相干断层扫描(OCT)测量下泪新月面积(LTMA)和总泪新月面积(TTMA),泪膜破裂时间(tBUT),基础泪液分泌(ST-II)等检查。数据采用重复测量数据方差分析,成组t检验及Pearson’s相关分析法。结果:总体上术后DES值B组显著低于A组(F=26.96,P=0.001);LTMA、TTMA值B组显著高于A组(分别F=56.21、39.36,均P<0.001);tBUT值B组显著高于A组(F=28.39,P=0.001);ST-II值B组显著高于A组(F=17.44,P=0.01)。术后1 d、1周B组DES值显著低于A组(分别t=1.89、1.55,均P<0.05)。术后1周B组LTMA、TTMA、ST-II值显著均高于A组(分别t=1.38、1.49、1.82,均P<0.05)。术后1周、1个月和3个月B组tBUT值均显著高于A组(t=2.32、2.09、1.58,均P<0.05)。其余时间点2组间差异均无统计学意义(均P>0.05)。与术前相比,2组DES值在术后1 d、1周均显著增高(均P<0.05),客观泪液功能指标仅A组在术后早期出现显著性改变,如LTMA(术后1 d、1周,分别P<0.05,P<0.01),TTMA(术后1 d、1周、1个月,分别P<0.01,P<0.01,P<0.05),tBUT(术后1周,P<0.05),ST-II(术后1周、1个月,均P<0.05);而B组与术前相比差异均无统计学意义(均P>0.05)。结论:1.8 mm透明角膜微切口白内障超声乳化手术对术后早期泪液功能的影响明显小于常规3.0 mm切口,在改善术后泪液功能和舒适度方面具有优势。
Objective： To explore the effect of different clear corneal incision size on change in tear func-tion after phacoemulsiifcation cataract surgery.Methods： Sixty patients （60 eyes） recruited for cataract surgery at the Eye Hospital of Wenzhou Medical University from November 2012 to May 2013 were randomly divided into two groups, A group （30 eyes） underwent regular 3.0 mm clear corneal incision phacoemulsiifcation, group B （30 eyes） underwent 1.8 mm clear corneal micro-incision phacoemulsiifcation. Before the surgery and 1 day, 1 week, 1 month, and 3 months after surgery, all subjects underwent measurements, including dry eye symptom score （DES）, lower tear meniscus area （LTMA） and total tear meniscus area （TTMA） by optical coherence tomography （OCT）, tear iflm break-up time （tBUT） and Schirmer test （ST-II）. Statistic analysis used repeated measurement data analysis of variance, t-test and Pearson’s correlation.Results： In general, comparing to group A, the postop-erative DES in group B was signiifcantly lower （F=26.96,P=0.001）, LTMA and TTMA in group B were signiif-cantly higher（F=56.21, 39.36, respectively, bothP〈0.001）, tBUT in group B was signiifcantly higher （F=28.39, P=0.001）, and ST-II in group B was signiifcantly higher （F=17.44,P=0.01）. On 1 day and 1 week after surgery, DES in group B was signiifcantly lower than that in group A（t=1.89, 1.55, respectively, bothP〈0.05）. On 1 week after surgery, LTMA, TTMA and ST-II in group B were signiifcantly higher than that in group A （t=1.38, 1.49, 1.82, respectively, allP〈0.05）. On 1 week, 1 month and 3 months after surgery, tBUT in group B was sig-niifcantly higher than that in group A （t=2.32, 2.09, 1.58, respectively, allP〈0.05）. No signiifcant difference was＆amp;nbsp;found at the other time points between the two groups. Comparing to the preoperative levels, DES in both groups increased on 1 day and 1 week after surgery （bothP〈0.05）. Only in group A, the objective tear functio
出处
《温州医学院学报》
CAS
2014年第5期342-347,共6页
Journal of Wenzhou Medical College
基金
温州市科技局科研基金资助项目(Y20130129)
温州医科大学眼视光学院
医院创新引导课题(YNCX201008)
关键词
白内障
超声乳化
角膜
泪液
干眼
cataract
phacoemulsiifcation
cornea
tear
dry eye
