白内障超声乳化及现代囊外摘除术对眼表影响探究.docVIP

白内障超声乳化及现代囊外摘除术对眼表影响探究 　［摘要］ 目的 对比研究白内障超声乳化术和现代囊外摘除术后眼表功能的变化。方法 选择156例186眼白内障患者，分为两组，分别行白内障超声乳化联合人工晶体植入术（PHACO组，98例114眼）和白内障现代囊外摘除联合人工晶体植入术（ECCE组，58例72眼）。术后1个月对干眼相关症状、体征、泪液分泌试验（Schirmer Ⅰ试验）、泪膜破裂时间（breakup time，BUT）、角膜荧光素染色、眼表虎红染色等项目进行检查和评分比较。结果 两组间在症状、体征、干眼诊断性试验等各项指标评分上差异均有显著性（P＜0.05），ECCE组评分明显高于PHACO组，ECCE组干眼症发病率（27.78％）也高于PHACO组（4.38%），其差异同样具有显著性（P＜0.05）。结论 白内障现代囊外摘除术较超声乳化术在术后短期内更易对眼表功能造成影响，使泪膜稳定性受到破坏而产生干眼症。 ［关键词］ 白内障；超声乳化术；现代囊外摘除术；干眼症 Effect of phacoemulsification and extracapsular cataract extraction on the eye surface Methods This clinical trial involved 156 patients (186 eyes) with cataract undergoing phacoemulsification (PHACO group， 98 cases 114 eyes) or extracapsular cataract extraction (ECCE group， 58 cases 72 eyes). The symptoms and signs of dry eye disease， Schirmer，s I test， break-up time (BUT)， corneal fluorescein staining， rosebengal staining were tested and marked 1month after operation. Comparison for the results was made between two groups. Results The marks of all the index such as symptom，signs and diagnostic test between two groups had significant difference (P＜0.05). Marks in ECCE group were significant higher than those in PHACO group. The rate of dry eye disease in the ECCE group (27.78％) was higher than that in the PHACO group (4.38%) and the difference was also significant (P＜0.05). Conclusion In a short term postoperatively， the extracapsular cataract extraction seems more easily to effect the function of eye surface and lead to dry eye disease than phacoemulsification. ［Key words］ cataract;phacoemulsification;extracapsular cataract extraction;dry eye disease 近年来，随着眼科显微手术技术的不断进步，以及人工晶体的不断发展更新，已有越来越多的白内障患者得以通过手术复明。超声乳化白内障手术是相对先进的手术方式，不但术后反应轻，恢复快，手术引起的散光也小。然而在一些不具备进行超声乳化手术的条件下，白内障小切口的现代囊外摘除术也是较常选用的术式。患者术后视力恢复的同时，也可能同时出现眼干涩、异物感等不适，其发生比率在不同手术方式下有所不同。本研究比较了两种不同手术方式对眼表泪膜功能的影响，现报告如下。 1 资料与方法 1.1 一般资料 2003年1月~2005年12月在我院行白内障手术病人共156例186眼。其中行白内障超声乳化联合人工晶体植入术98例114眼，行白内障现代囊外摘除联合人工晶体植入术58例72眼；男86例92眼，女70例94眼；年龄48～82岁，平均65.8岁。 1.2 排除标准 妊娠、哺