[1]阳光,何异,范松涛.不同大小透明角膜切口对白内障超声乳化术后泪膜的影响[J].眼科新进展,2015,35(12):1173-1176.[doi:10.13389/j.cnki.rao.2015.0321]
　YANG Guang,HE Yi,FAN Song-Tao.Effects of different corneal incision sizes on tear film after phacoemulsification[J].Recent Advances in Ophthalmology,2015,35(12):1173-1176.[doi:10.13389/j.cnki.rao.2015.0321]
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不同大小透明角膜切口对白内障超声乳化术后泪膜的影响
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年12期
页码:
1173-1176
栏目:
应用研究
出版日期:
2015-12-05

文章信息/Info

Title:
Effects of different corneal incision sizes on tear film after phacoemulsification
作者:
阳光; 何异; 范松涛
610017　四川省成都市，成都市第二人民医院眼科
Author(s):
YANG Guang;  HE Yi; FAN Song-Tao
Department of Ophthalmology,the Second People ’ s Hospital of Chengdu, Chengdu 610017 , Sichuan Province . China
关键词:
泪膜; 白内障; 光学相干断层扫描; 泪河
Keywords:
tear film ;  cataract ;  optical coherence tomography ;  tear meruscus
DOI:
10.13389/j.cnki.rao.2015.0321
文献标志码:
A
摘要:
目的　采用光学相干断层扫描（ｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ，ＯＣＴ）和其他泪膜检测指标评估不同大小的角膜切口对白内障超声乳化术后泪膜的影响。方法　随机将年龄相关性白内障患者７９例９８眼分为２．２ｍｍ组（４６眼）和３．０ｍｍ组（５２眼），均行超声乳化白内障吸出联合人工晶状体植入术，于术前、术后１ｄ、７ｄ、１个月及３个月检测基础泪液分泌（ｓｃｈｉｒｍｅｒＩｔｅｓｔ，ＳⅠＴ）、泪膜破裂时间（ｂｒｅａｋ-ｕｐｔｉｍｅ，ＢＵＴ）、干眼症状（ｄｒｙｅｙｅｓｙｍｐｔｏｍｓ，Ｓｘ）评分，并采用ＲＴＶｕｅＯＣＴ检测泪河面积（ｔｅａｒｍｅｎｉｓ-ｃｕｓａｒｅａ，ＴＭＡ）、泪河高度（ｔｅａｒｍｅｎｉｓｃｕｓｈｅｉｇｈｔ，ＴＭＨ）及泪河深度（ｔｅａｒｍｅｎｉｓｃｕｓａｒｅａｄｅｐｔｈ，ＴＭＤ），对两组各项检测结果进行比较。结果　与术前相比，术后１ｄ、７ｄ、１个月时２．２ｍｍ组及３．０ｍｍ组的Ｓｘ评分均升高（均为Ｐ＜０．０５），术后３个月时与术前差异均无统计学意义（均为Ｐ＞０．０５）；术后７ｄ时２．２ｍｍ组及３．０ｍｍ组的ＢＵＴ、ＳⅠＴ均不同程度降低（均为Ｐ＜０．０５），至术后１个月时２．２ｍｍ组的ＳⅠＴ仍较低（Ｐ＜０．０５），而ＢＵＴ与术前差异无统计学意义（Ｐ＞０．０５），３．０ｍｍ组的ＢＵＴ、ＳⅠＴ仍不同程度降低（均为Ｐ＜０．０５）；术后１ｄ、７ｄ时２．２ｍｍ组及３．０ｍｍ组的ＴＭＡ、ＴＭＨ及ＴＭＤ均比术前明显减小（均为Ｐ＜０．０５），术后１个月时２．２ｍｍ组的ＴＭＡ、ＴＭＨ及ＴＭＤ与术前差异均无统计学意义（均为Ｐ＞０．０５），而３．０ｍｍ组的ＴＭＡ及ＴＭＤ仍比术前明显减小（均为Ｐ＜０．０５），ＴＭＨ与术前差异无统计学意义（Ｐ＞０．０５）。两组之间相比，２．２ｍｍ组的Ｓｘ评分在术后１ｄ、７ｄ时均比３．０ｍｍ组低，差异均有统计学意义（均为Ｐ＜０．０５），术后１个月及３个月时两组的Ｓｘ评分差异均无统计学意义（均为Ｐ＞０．０５）；２．２ｍｍ组的ＢＵＴ、ＳⅠＴ在术后７ｄ时均明显高于３．０ｍｍ组（均为Ｐ＜０．０５），术后１个月及３个月时两组差异均无统计学意义（均为Ｐ＞０．０５）；术后１ｄ、７ｄ时，２．２ｍｍ组的ＴＭＡ、ＴＭＨ及ＴＭＤ均显著高于３．０ｍｍ组（均为Ｐ＜０．０５），术后１个月及３个月时两组差异均无统计学意义（均为Ｐ＞０．０５）。结论　与３．０ｍｍ透明角膜切口相比，２．２ｍｍ透明角膜切口对眼表泪膜的影响更小，恢复更快。
Abstract:
Objective To evaluate the effects of different corneal incision sizes on tear film after phacoemulsification by optical coherence tomography ( OCT) and other tear film examinations. Methods Ninty-eight eyes of 79 cases were randomly divided int0 2. 2 mm incision group and 3. 0 mm incision group, then were performed by phacoemulsification and intraocular lens implantation. Schirmer I test ( SIT) . tear film break-up time ( BUT) and dry eye symptoms ( Sx) at pre-operation and postoperative I day,7 days ,1 month ,3 months were detected . and tear meniscus area ( TMA) , tear meniscus height ( TMH) and tear meniscus depth ( TMD) were also measured by RTVue OCT. The results were compared between the two groups. Results Sx of 2. 2 mm group and 3. 0 mm group at I day ,7 days,l month postoperatively were higher than that preoperatively ( all P < 0. 05 ) , while there was no difference of Sx between 3 month postoperatively and preoperatively(P > 0. 05 ) ; BUT and SIT of 2. 2 mm group and 3. 0 mm group at 7 days postoperatively were all decreased( all P < 0. 05 ) ;SIT of 2. 2 mm group at I month postoperatively was still lower than preoperatively ( P < 0. 05 ) . while there was no difference of BUT of 2. 2 mm group between postoperatively and preoperatively (P > 0. 05 ) ;BUT and SIT of 3. 0 mm group at I month postoperatively decreased ( all P < 0. 05 ) ;TMA , TMH and TMD of 2. 2 mm group and 3. 0 mm group at I day ,7 days postoperatively were dramatically decreased than that preoperatively ( all P < 0. 05 ) . TMA.TMH and TMD of 2. 2 mm group was no statistically different at I month postoperatively and preoperatively ( all P > 0. 05 ) ; TMA and TMD of 3. 0 mm group at I month postoperatively were still decreased than preoperatively ( all P < 0. 05 ) , while there was no difference of TMH of 3. 0 mm group between postoperatively and preoperatively ( P > 0. 05) . No difference existed of 2. 2 mm group and 3. 0 mm group at 3 months between postoperatively and preoperatively(P > 0. 05 ) . Sx of 2. 2 mm group at I day ,7 day post-operatively was lower than those of 3. 0 mm group , and the differences were statistically significant ( all P < 0. 05 ) .while there was no difference of Sx at I month .3 months postoperatively between the two groups( all P > 0. 05 ) ; BUT and SIT of 2. 2 mm group were higher than those of 3. 0 mm group at 7 day postoperatively( all P < 0. 05 ) . while there was no statistical difference of BUT and SIT at I month and 3 month postoperatively between the two groups( all P > 0. 05 ) ;TMA . TMH and TMD of 2. 2 mm group at I day , 7 days postoperatively were all dramatically higher than those of 3. 0 mm group ( all P < 0. 05 ) , while there was no statistical difference of TMA.TMH and TMD at I month and 3 month postoperatively between the two groups( all P > 0. 05 ) . Conclusion 2. 2 mm clear corneal incision has less effect on tear film than 3. 0 mm clear corneal incision.

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更新日期/Last Update: 2015-12-07