·临床研究·DOI:10.3969/j.issn.100320808.2010.10.023作者单位:200040上海市眼病防治中心通讯作者:袁胤(Email:cat1902@hotmail.com)白内障超声乳化术角巩膜缘切口对术后泪膜稳定性的影响袁胤庄槿邱立红InfluenceofcorneosclerallimbusincisionontearfilmstabilityafterphacoemulsificationYUANYin,ZHUANGJin,QIULi2hong.DepartmentofOphthalmology,ShanghaiEyeDiseasePreventionandTreatmentCenter,Shanghai200040,ChinaAbstractBackgroundCorneoscleralrimincisionhaslessimpactsoneitherthecornealepitheliumandconjunctivaorthecornealsensation.Buttheeffectsofthisoperativeincisiononthestabilityoftearfilmafteroperationisunclear.ObjectivePurposeofthisstudywastoexplorethechangesoftearfilmafterphacoemulsificationandintraocularlens(IOL)implantationviacorneoscleralrimincision.MethodsSmallincisionphacoemulsificationandIOLimplantationwasperformedin219eyesof128patientswithage2relatedcataractfromJuly2006toDecember2008.Thesurgeryeyeswererandomlydividedintocorneoscleralrimincisiongroup(69eyesof42cases),cornealtransparencyincisiongroup(70eyesof45cases),scleraltunnelincisiongroup(80eyesof41cases).Nosignificantdifferenceswerefoundindemographyofclinicaldataamongthesethreegroups(P>0105).Dryeyesymptomsscore,Schirmertest(SIt),tearfilmbreak2uptime(BUT)andcornealfluoresceinstaininginoperativeeyeswereevaluatedbeforesurgeryand1day,2,7and30daysaftersurgery.Writteninformedconsentwasobtainedfromeachsubjectpriortothetrial.ResultsTheclinicalscoreofdryeyesymptomswasshowedtobesignificantlydifferentamongcorneoscleralrimincisiongroup,cornealtransparencyincisiongroupandscleraltunnelincisiongroup(F=99145,P=0101)indifferenttimepoints(F=110151,P=0100).Thescorewasgraduallydeclinedfrom1dayto14daysafteroperationandwasstableafterthat,showingobviousdifferencesincomparisonwithpreoperation(P<0101),andthatincorneoscleralrimincisiongroupwasevidentlylowerthancornealtransparencyincisiongrouporscleraltunnelincisiongroup(P<0101).TheBUTwassignificantlylesswithin14daysafteroperationthanthatofpreoperationincornealtransparencyincisiongrouporscleraltunnelincisiongroup(P<0101),butnoobviousdifferencewasfoundincorneoscleralrimincisiongroupindifferenttimepoints(P>0105),andtheBUTvaluewaslowestincornealtransparencyincisiongroupfrom1daythrough14daysafteroperation.Incorneoscleralrimincisiongroup,Schirmertestwasreducedfrom1daythrough14daysafteroperationwiththehighestvalueinthefirstdayafteroperation,showingstatisticallysignificantdifferenceinvariousgroups(P<0101).Thecornealfluoresceinstainingrevealedthatthescorewassignificantlyincreasedfrom1daythrough14dayafteroperationincomparisonwithbeforeoperationincornealtransparentincisiongroup(P<0105),andthescorewashigherthanothertwogroupsinthesetimepoints(P<0105).Noconsiderabledifferencewasseenincornealfluoresceinstainingscoreamongvarioustimepointsincorneoscleralrimincisiongroupandscleraltunnelincisiongroup(P>0105).ConclusionCorneoscleralrimincisiondoesnotproductadverseinfluenceonthestabilityoftearfilmaftersmallincisionphacoemulsificationandIOLimplantation.Theseresultssuggestthatcorneoscleralrimincisionisabetterselectinphacoemulsificationcataractsurgeryforthecataractouseyewithahighriskofdryeye.Keywordscorneoscleralrimincision;phacoemulsification;tearfilm;dryeye;cataract摘要目的探讨角巩膜缘切口对白内障超声乳化术后泪膜变化的影响。方法研究为临床疗效评价的病例对照研究。收集2006年7月—2008年12月行小切口白内障超声乳化及人工晶状体(IOL)植...
