方法：收集2015-01/10在我院接受超声乳化术的2型糖尿病患者150例150眼。按照随机数字表，将其分为两组，A组微切口组(75例75眼)行2.2mm透明角膜微切口白内障超声乳化术，B组小切口组(75例75眼)行常规3.0mm透明角膜切口白内障超声乳化术，两组资料的人口统计学特征差异无统计学意义。观察并比较两组患者术前及术后1wk，1、3、6mo的眼表疾病指数(ocular surface disease index，OSDI)、角膜知觉、泪膜破裂时间(break-up time，BUT)和基础泪液分泌试验(Schirmer's Ⅰtest，SⅠt)指标的变化。

结果：术后1wk，1、3mo，两组患者的OSDI评分均高于术前，且B组的OSDI评分明显高于A组，差异有统计学意义(均P<0.05)； 两组患者的角膜知觉均较术前降低，且B组的角膜知觉明显低于A组，差异具有统计学意义(均P<0.05)； 两组患者的SⅠt均低于术前，且B组的SⅠt明显低于A组，差异具有统计学意义(均P<0.05)。术后1wk，1mo，两组患者的BUT均低于术前，且B组的BUT明显低于A组，差异具有统计学意义(均P<0.05)。术后6mo，A组患者的OSDI、角膜知觉、BUT和SⅠt与术前相比差异不明显，无统计学意义(均P>0.05)； B组患者的OSDI评分和角膜知觉与术前相比差异明显，具有统计学意义(均P<0.05)； BUT和SⅠt与术前相比差异不明显，无统计学意义(均P>0.05)。

结论：2.2mm透明角膜微切口对眼表及泪膜的影响较小，对并发白内障的2型糖尿病患者尤为适用。

METHODS:One hundred and fifty patients with type 2 diabetes(150 eyes)from Jan. 2015 to Oct. 2015 in our hospital were enrolled. The patients were randomly divided into two groups. Seventy-five patients(75 eyes)in group A: coaxial 2.2mm micro-incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation; seventy-five patients(75 eyes)in group B: the conventional coaxial 3.0mm small incision phacoemulsification cataract extraction and IOL implantation. The difference of demographic characteristics between two groups were insignificant. The ocular surface disease index(OSDI), corneal sensation, break up time(BUT)and Schirmer's Ⅰ test(SⅠt)were examined preoperatively and 1wk, 1, 3 and 6mo postoperatively.

RESULTS:At 1wk, 1 and 3mo postoperatively, the OSDI score in two groups increased and the OSDI score of group B was significantly higher than those of group A and the differences were statistically significant(all P<0.05). The corneal sensation in two groups decreased after operations and the corneal sensation of group B was significantly lower than those of group A and the differences were statistically significant(all P<0.05). The SⅠt in two groups decreased after operations and the SⅠt of group B was significantly lower than those of group A and the differences were statistically significant(all P<0.05). At 1wk and 1mo postoperatively, the BUT in two groups decreased after operations and the BUT of group B was significantly lower than those of group A and the differences were statistically significant(all P<0.05). At 6mo postoperatively, no significant change was found in the OSDI score, corneal sensation, BUT and SⅠt of group A compared with preoperatively(all P>0.05). At 6mo postoperatively, the differences of OSDI score and corneal sensation in group B were statistically significant compared with preoperatively(all P<0.05)while no significant change was found in the BUT and SⅠt of group B(all P>0.05).

CONCLUSION:Phacoemulsification surgery with 2.2mm corneal micro-incision has less effect on change in tear function comparing to the 3.0 mm incision control, which can be applied particularly in patients with type 2 diabetes.