方法：纳入2014-04/12于我院就诊并行白内障超声乳化吸除联合人工晶状体(IOL)植入术的老年性白内障住院患者74例100眼。按照患者是否有糖尿病史分为两组，A组：有3a以上糖尿病史患者，34例50眼； B组：无糖尿病史患者40例50眼。分别于手术前和术后第1d，1、2wk，1mo，观察比较患者的干眼症状评分、泪膜破裂时间(break-up time，BUT)、角膜荧光素染色评分(fluorescent，FL)、泪液分泌试验(Schirmer's Ⅰ test，SⅠt)及角膜内皮细胞等指标，对结果进行统计学分析。

结果：术前，两组患者的干眼症状评分、FL评分、BUT值、SⅠt值、平均内皮细胞面积及内皮细胞数差异均无统计学意义(P>0.05)。两组患者术后各观察时间点的干眼症状均明显重于术前(P<0.05)。A组术后各时间点FL评分和SⅠt值均明显高于术前，BUT明显短于术前(P<0.05)； B组术后1d，1、2wk时FL评分和SⅠt值均明显高于术前，术后1d、1wk时BUT明显短于术前(P<0.05)。两组患者术后平均内皮细胞面积均大于术前，A组术后2wk开始变化差异有统计学意义，B组术后1wk开始变化差异有统计学意义(P<0.05)。两组患者术后各时间点的角膜内皮细胞数均显著少于术前，差异有统计学意义(P<0.05)。A组和B组间比较，术后1mo时各指标变化差异均有统计学意义(P<0.05)。

结论：白内障超声乳化手术对糖尿病白内障患者眼表的影响大于单纯白内障患者，临床上需加以注意。

METHODS: A total of 74 patients with cataract and diabetes(100 eyes)who underwent phacoemulsification of senile cataract combined with intraocular lens(IOL)implantation were selected in our hospital from Apr.2014 to Dec.2014, and they were divided into the group A and group B according to with/without a history of diabetes. A total of 34 patients(50 eyes)with a history of diabetes more than 3y were assigned to group A, and 40 patients(50 eyes)without history of diabetes were assigned to group B. The dry eye-related symptom score, corneal fluorescein(FL)score, tear film break-up time(BUT), Schirmer Ⅰ test(SⅠt)and corneal endothelial cells were examined and compared in pre-therapy and post-treatment, respectively.

RESULTS: Before operation, there was no significant difference on the dry eye-related symptom score, FL score, BUT, SⅠt and corneal endothelial cells between the two groups(P>0.05). After operation, the dry eye-related symptom score in group A and B were both greatly higher than that before operation(P<0.05). The FL score and SⅠt in group A after operation were both higher but BUT was lower than that before operation(P<0.05). In group B, the FL score and SⅠt were both higher on first day, 1 week, and 2 weeks after operation than that before operation, However, the BUT was lower on 1d and 1wk after operation than that before operation(P<0.05). All the observation indexes were restored in 1mo after operation. After operation, endothelial cell area in the two groups were both larger than that before operation, and the significant difference were found from 2wk after operation in group A but only 1wk after operation in group B(P<0.05). The number of corneal endothelial cells in group A and B after operation were both less than that before operation(P<0.05). All the observation targets between group A and B had a significant difference in 1mo after operation(P<0.05).

CONCLUSION: The cataract phacoemulsification has a significant influence in ocular surface of patients with cataract and diabetes than that without diabetes.