飞秒激光辅助白内障手术对泪液质量影响的临床研究被引量：4

Clinical study of influence on the quality of tear after femtosecond laser assisted cataract surgery

下载PDF

导出

摘要目的观察飞秒激光辅助白内障手术后泪液质量的变化。方法前瞻性病例对照研究。将2016年1月至2017年8月在深圳爱尔眼科医院住院手术治疗的161例(161只眼)非干眼年龄相关性白内障患者纳入研究对象,根据不同术式分为两组:观察组86例,实施飞秒激光辅助白内障超声乳化+人工晶状体植入术;对照组75例,实施白内障超声乳化+人工晶状体植入术。术前和术后1周、1个月、3个月时两组患者分别做泪膜破裂时间(BUT)、泪液分泌试验(SIt)、角膜荧光素染色(FL)检查,记录两组患者在上述不同时期BUT、SIt、FL。结果BUT:观察组与对照组术前和术后1周、1个月、3个月分别为:(14. 55±2. 42) s、(14. 15±2. 12) s、(13. 24±1. 59) s、(14. 01±2. 06) s、(14. 71±2. 44) s、(14. 15±1. 97) s、(13. 11±1. 17) s、(13. 17±1. 47) s。两组BUT术前和术后1周、1个月的差异无统计学意义(P> 0. 05),术后3个月的差异有统计学意义(P <0. 05)。SIt:观察组与对照组术前和术后1周、1个月、3个月分别为:(19. 31±4. 94) mm、(19. 05±4. 60) mm、(16. 55±3. 79) mm、(18. 95±4. 27)mm、(18. 93±4. 64) mm、(18. 80±4. 05) mm、(16. 71±3. 55) mm、(17. 43±3. 93) mm;两组SIt术前和术后1周、1个月的差异无统计学意义(P> 0. 05),术后3个月的差异有统计学意义(P <0. 05)。FL:观察组术与对照组术前和术后1周、1个月、3个月分别为:0. 43±0. 54、1. 37±0. 87、0. 88±0. 60、0. 40±0. 49、0. 36±0. 48、1. 84±0. 70、1. 16±0. 52、0. 55±0. 50。两组FL术前和术后3个月的差异无统计学意义(P> 0. 05),术后1周、1个月时差异有统计学意义(P <0. 05)。结论飞秒激光辅助白内障手术和白内障超声乳化手术都会影响术后泪液质量,飞秒激光辅助白内障手术对泪液质量的影响低于白内障超声乳化术。 Objective To observe the changes of the tear quality after the femtosecond laser assisted cataract surgery. Methods In the prospective case-control study, 161 eyes of non dry eye age-related cataract patients who were operated in Shenzhen Aier ophthalmology hospital from January 2016 to August 2017 were selected and divided into two groups according to the different operative methods. In the experimental group, 86 eyes were underwent femtosecond laser assisted cataract surgery combined with intraocular lens implantation,in the control group, 75 eyes were underwent phacoemulsification combined with intraocular lens imlantation. Two groups of patients were performed Schirmer test （Schirmer I test, SIt）, break-up time （break up time of tear film, BUT）, corneal fluorescein staining （FL）, and were recorded in S1t,BUT,FL preoperatively and 1 week,1month,3months postoperatinely. Results The BUT of the experimental group and the control group preoperatively and 1 week,1 month,3 months postoperatively was respectively：（14.55±2.42）s,（14.15±2.12）s,（13.24±1.59）s,（14.01±2.06）s,（14.71±2.44）s,（14.15±1.97）s,（13.11±1.17）s,（13.17±1.47）s. Between the two groups, there was no statistically significant difference in BUT preoperatvely and 1 week,1 month postoperatively （ P 〉0.05）,and there was statistically significant difference 3 months postoperatively （ P 〈0.05） .The SIt of the experimental group and the control group preoperatively and 1 week,1 month,3 months postoperatively was respectively：（19.31±4.94）mm,（19.05±4.60）mm,（16.55±3.79）mm,（18.9±4.27）mm,（18.93±4.64）mm,（18.80±4.05）mm,（16.71±3.55）mm,（17.43±3.93）mm.Between the two groups,there was no statistically significant difference in the S1t between two groups preoperatively and 1 week,1 month postoperatively （ P 〉0.05）, and there was statistically significant difference 3 months postoperatively （ P 〈0.05）between the two groups.The FL of the experimental group