方法： 选取施行青光眼白内障联合手术的患者75例75眼，以手术眼为手术眼组，以未手术眼为对照眼组。于术后1mo对干眼相关症状、泪液分泌试验(Schirmer Ⅰ test， SⅠt)、泪膜破裂时间(break-up time， BUT)、角膜荧光素染色、眼压、视力等项目进行检查评分，并比较两组间各项结果差异。

结果：患者术后1mo的平均眼压为16.25±0.46mmHg，与术前3d的眼压45.29±4.39mmHg相比较，差异性具有统计学意义(P<0.05)。术前平均视力0.08±0.06，术前矫正视力：<0.05为23眼，≥0.05～<0.1为16眼，≥0.1～<0.3为36眼。术后1mo矫正视力：<0.05者7眼(9%)，≥0.05～<0.1者11眼(15%)，≥0.1～<0.3者38眼(51%)，≥0.3～<0.5者11眼(15%)，≥0.5者8眼(11%)，术后平均视力0.15±0.1。患者术眼视力与术前相比有明显提高，差异有统计学意义(P<0.05)。两组间术后的术眼干眼症状与对照组眼相比均呈增高趋势，干眼症诊断性试验各项指标与对照眼组相比，差异具有统计学意义(P<0.05)。

结论：青光眼白内障联合手术可在术后对眼表和泪膜功能造成影响，使泪膜稳定性受到破坏而产生干眼症。

METHODS:This clinical trial involved 75 patients(75 eyes)with glaucoma complicated with cataract undergoing combined glaucoma and cataract surgery. All the eyes were divided into surgical group(the eyes undergoing operation)and control group(the other eyes).The symptoms and signs of dry eye disease, Schirmer's I test, break-up time(BUT), corneal fluorescein staining were tested and marked 1mo after operation. Comparison of the results was made between two groups.

RESULTS: The average intraocular pressure was 16.25±0.46mmHg at 1mo after operation, compared with 45.29±4.39mmHg at 3d before surgery, the difference was statistically significant(P<0.05). Preoperative average visual acuity was 0.08±0.06, corrected visual acuity was <0.05 in 23 eyes, ≥0.05 to <0.1 in 16 eyes, ≥0.1 to <0.3 in 36 eyes. Postoperatively 1mo, corrected visual acuity: <0.05 for 7 eyes(9%), ≥0.05 to <0.1 for 11 eyes(15%), ≥0.1 to <0.3 for 38 eyes(51%), ≥0.3 to <0.5 for 11 eyes(15%), ≥0.5 for 8 eyes(11%), postoperative visual acuity was 0.15±0.1, which was significantly higher than before surgeries(P<0.05). The postoperative dry eye symptoms of surgical group was higher, compared with that of control group, and the differences of diagnosis of dry eye test indicators between the two groups were statistically significant(P<0.05).

CONCLUSION: Combined cataract and glaucoma surgery may affect postoperative ocular surface and tear film function, make the tear film stability damaged and lead to dry eye disease.