羟糖苷与玻璃酸钠对年龄相关性白内障术后干眼的疗效比较

Comparsion on therapeutic effect of hydroxyl-glucoside and sodium hyaluronate on dry eye after age-related cataract surgery

摘要:

目的：观察年龄相关性白内障超声乳化摘除联合囊袋内人工晶状体植入术后泪膜的变化，比较羟糖苷滴眼液与玻璃酸钠滴眼液治疗术后干眼的临床疗效。

方法：选择术前无干眼的年龄相关性白内障患者，行超声乳化摘除联合囊袋内人工晶状体植入术后发生干眼的患者49例70眼，完全随机分为治疗1组(A组)、治疗2组(B组)、对照组(C组)。A组23眼术后给予常规抗炎治疗，并于术后第7d联合应用羟糖苷滴眼液，B组22眼术后给予常规抗炎治疗，并于术后第7d联合应用玻璃酸钠滴眼液， C组25眼术后只给予常规抗炎治疗，不加用任何人工泪液，分别于术前2d； 术后 7，14，30，90d对三组行干眼主观症状问卷调查、基础泪液分泌试验(Schimer I test， SⅠt)、泪膜破裂时间(break-up time， BUT)、角膜荧光素染色(cornea fluorescein staining，CFS)评分。

结果：手术前2d三组间干眼症状评分、SⅠt，BUT，CFS检查值差异无统计学意义(P>0.05)，术前2d及术后90d三组组间比较主观症状评分、SⅠt，BUT，CFS等检查值差异无统计学意义(P>0.05)，但各组组内术前与术后7，14，30d比较差异有统计学意义(P<0.05)。术后14，30d A组及B组与C组两两比较主观症状、SⅠt，BUT，CFS均有不同程度改善，组间差异有统计学意义(P<0.05)。术后30d B组SⅠt，BUT较A组均有不同程度改善，差异有统计学意义(P<0.05)。

结论：白内障超声乳化摘除联合囊袋内人工晶状体植入术后早期泪膜稳定性明显下降，并出现干眼症状，加用羟糖苷滴眼液或玻璃酸钠滴眼液对恢复泪膜结构及稳定性有一定作用，从而改善干眼症状，而玻璃酸钠滴眼液效果更明显。

Abstract:

AIM: To observe the tear film changes after phacoemulsification combined with intraocular lens implantation in age-related cataract patients and to compare the therapeutic effect of hydroxyl-glucoside and sodium hyaluronate on the postoperative dry eye.

METHODS: A total of 49 patients(70 eyes)with age-related cataract suffering from dry eye after phacoemulsification combined with IOL implantation were divided into treatment group 1(group A, 23 eyes with conventional therapy and hydroxyl-glucoside at 7d postoperatively), treatment group 2(group B, 22 eyes with conventional therapy and sodium hyaluronate at 7d postoperatively)and control group(group C, 25 eyes with conventional therapy only). Questionnaire score of dry eye symptoms, SchirmerⅠtest(SⅠt), tearfilm break up time(BUT)and corneal fluoresce in staining(CFS)were measured at 2d preoperatively and 7, 14, 30, 90d postoperatively.

RESULTS: No statistical differences existed among the three groups of preoperative 2d(P>0.05). At 2d preoperatively and 90d postoperatively, the results of questionnaire score of dry eye symptoms, SⅠt, BUT, and CFS displayed no statistical differences in the patients of three groups(P>0.05). While there was statistical significance among preoperatively and 7, 14, 30d postoperatively of the three groups(P<0.05). At 14, 30d postoperatively, the questionnaire score of dry eye symptoms, SⅠt, BUT, CFS in group A and B were better than in group C, which displayed statistical differences(P<0.05). At 30d postoperatively the questionnaire score of dry eye symptoms, SⅠt, BUT in group B were better than in group A, which displayed statistical differences(P<0.05).

CONCLUSION: At the early stage after phacoemulsification combined with IOL implantation, the tear film stability is decreased, which may promote eyesymptoms. Management with hydroxyl-glucoside or sodium hyaluronate plays a role in relief of the structure and stability of the tear film and improves dry eye symptoms, while sodium hyaluronate eye drops is more effective.