角巩膜缘切口对白内障超声乳化术后泪膜变化影响.docVIP

角巩膜缘切口对白内障超声乳化术后泪膜变化影响 　　摘要：目的：探讨白内障超声乳化术中不同手术切口对术后泪膜稳定性的影响。方法：选取我院自2013年1月～2015年2月收治的62例白内障患者作为研究对象，所有患者均行超声乳化摘除术联合人工晶体植入术。根据手术切口不同将患者分为透明角膜切口与角巩膜隧道切口组。于术前3d以及术后第1、7、30、90天对两组患者的干眼主观症状、SIt试验结果及BUT进行分析比较。结果：术后第1、7天，两组患者的干眼症状得分与术前相比均明显升高（P0.05）；组间比较，透明角膜切口组患者术后第1、7天的干眼症状得分显著低于角巩膜隧道切口组，角膜切口组（P0.05）。术后第1、7、30、90天，两组患者的SIt均较术前显著增加（P0.05）；组间比较，术后第1天透明角膜切口组患者的Sit显著低于角巩膜隧道切口组（P0.05）。术后第1、7、30天，两组患者的BUT较术前显著缩短（P0.05），术后第90天均较术前显著延长（P0.05）；组间比较，透明角膜切口组患者术后第1、7天的BUT明显短于角巩膜缘切口组（P0.05）。结论：采用角巩膜隧道切口，由于切口部位优势，术中神经损伤较少，对角膜稳定性影响较小，有效减少患者术后干眼症的发生，可作为白内障超声乳化术首选的切口方法。 　　关键词：角巩膜缘切口；白内障超声乳化术；泪膜 　　Abstract：Objective：To study the impacts of different corneoscleral limbus incisions in the tear film stability after phacoemulsification. Method：62 patients with cataracts treated from January2013 to February 2015 in our hospital were selected and received the phacoemulsification associated with intraocular lens implantation. Based on the different incisions， the patients were divided into clear corneal incision group and sclera tunnel incision group. Before 3d of surgery and after 1d， 7d， 30d and 90d of surgery， the subjective dry eye symptoms， SIt test results and BUT of two groups were compared. Result：After 1d and 7d of surgery， the dry eye symptom score of two groups was significantly higher than before （P0.05）； after 1d and 7d of surgery， the dry eye symptom score of clear corneal incision group was significantly lower than that of sclera tunnel incision group （P0.05）； after 1d， 7d， 30d and 90d of surgery， SIt of two groups was significantly higher than before （P0.05）； after 1d of surgery， SIt of clear corneal incision group was significantly lower than that of sclera tunnel incision group （P0.05）； after 1d， 7d and 30d of surgery， BUT of two groups was significantly shorter than before （P0.05）； after 90d of surgery， BUT of two groups was significantly longer than before （P0.05）； after 1d and 7d of surgery， BUT of clear corneal incision group was significantly shorter than that of scle