摘要
目的 使用新型四代角膜地形图仪（Keratograph4,oculuS,德国）比较上方透明角膜缘切口和水平透明角膜缘切口的同轴微切口白内障超声乳化手术（microincision coaxial cataract surgery）前后泪膜的变化.方法 前瞻性临床病例对照研究.对2014年6～9月在宜昌爱尔眼科医院随机选取年龄相关性白内障患者共142例142只眼,根据白内障手术方式分为两组：第一组接受上方透明角膜缘切口的同轴微切口白内障超声乳化手术,共75例,第二组接受水平透明角膜缘切口的同轴微切口白内障超声乳化手术,共67例.随访3个月,使用新型四代角膜地形图仪比较术前术后两组非侵犯性泪膜破裂时间（NIBUT）、泪河高度、基础泪液分泌试验（Schirmer I test）及患者主观干眼感觉评分值.比较各项结果在术后不同时间与术前的差异以及手术对两组病人影响程度的差异.结果 两组NIBUT、泪河高度、SIt及主观干眼感觉评分值比较差异有统计学意义（F组别=7577.541,P＜0.001;F组别=9523.241.P＜0.001;F组,=6781.533.P＜0.001;F组别=4796.753,P＜0.001）,术后1d、7d及1个月水平透明角膜缘切口组NIBUT及泪河高度明显低于上方透明角膜缘切口组,而术后各时期水平透明角膜缘切口组干眼感觉评分值明显高于上方透明角膜缘切口组,两组患者手术前后不同时间的NIBUT、泪河高度、SIt及主观干眼感觉评分值不全相同（F时间=24422.500,P＜0.001,F时间=8459.923,P＜0.001;F时间=5649.853,P＜0.001;F时间=5649.853,P＜0.001）.进一步的两两比较,术前NIBUT、泪河高度、SIt及主观干眼感觉评分值分别与术后1d,7d,1 m比较差异有统计学意义（P均＜0.001）,但术后3个月均恢复至术前水平.结论 与水平透明角膜缘切口的同轴微切口白内障超声乳化手术相比,上方透明角膜缘切口的同轴微切口白内障超声乳化手术对眼表的影响更小,患者术后早期干眼症状更轻微,术后�
Objective To compare the changes in tear film after Microincision coaxial cataract surgery with different direction of clear comea incisions with Keratograph 4.Methods A clinical case-control study.One hundred and forty-two patients （142 eyes） with age-related cataract were divided into two groups according to the surgical approach.Non-invasive tear break time （NIBUT）,tear meniscus height,schirmer I test and subjective score for dryness were compared between two groups.Results One day,7 days and 1 month postoperatively,both the mean NIBUT and tear meniscus height of the clear cornea incision above margin group reduced greatly than the clear cornea incision margin level group.The differences among two groups had significance statistically （Fgroup dift=7577.541,P 〈0.01;Fgroup dift=9523.241,P 〈0.01）.The values recovered to preoperative levels at 3 months postoperatively and there was no statistically significant difference among the two groups.At 1 day,7 days,1 month and 3 months postoperatively,the mean subjective scores for dryness of the a clear cornea incision margin level group were higher than the clear cornea incision above margin group;and a statistically significant difference among the two groups （Fgroup dift=6781.533,P 〈0.01）.All of the values recovered to preoperative levels at 3 months postoperatively.Conclusions A clear cornea incision above margin phacoemulsification bring less disturbance to ocular surface,brighter symptoms of dry eye and the patients feel more comfortable.
出处
《中国实用眼科杂志》
2017年第4期375-379,共5页
Chinese Journal of Practical Ophthalmology
