方法：选取2015-02/2016-02我院接受超声乳化术的白内障患者70例92眼。采取随机分组的方式，将其分为两组，分别为A组和B组，每组各46眼。A组采用2.5mm同轴超声乳化白内障术(34例46眼)，B组采用3.0mm同轴超声乳化白内障术(36例46眼)。观察两组患者的BUT(break-up time)、SⅠt(Schirmer's Ⅰ test)和睑缘平行的结膜皱褶(LIPCOF)，比较各项结果对患者影响程度的差异。

结果：两组患者的BUT于术后1wk，1、3mo时与术前相比均低于术前，其差异均具有统计学意义(P<0.05)，其中A组高于B组(t=3.089、4.497、4.322，均P<0.01)； 两组患者术后1wk，1、3mo时的 SⅠt与术前相比均高于术前，其差异均具有统计学意义(P<0.05)，其中A组低于B组(t=-6.286、-3.992、-3.278，均P<0.01)； 两组患者术后1wk，1、3mo时的LIPCOF与术前相比均高于术前，其差异性具有统计学意义(P<0.05)，其中A组低于B组，差异有统计学意义(t=-6.552、-5.131、-3.652，均P<0.01)。术后6mo时，A组患者的BUT、SⅠt 和LIPCOF与术前比较，其差异则无统计学意义(t=0.646、0.551、0.165，均P>0.05)； B组患者的BUT、SⅠt 和LIPCOF与术前比较，其差异具有统计学意义(t=-4.059、3.629、4.211，均P<0.05)。

结论：白内障超声乳化手术切口大小可影响术后泪膜的变化，手术切口的减小不仅可以降低对眼表组织的损伤，而且可以减轻对术后泪膜的影响。

METHODS: Seventy patients(92 eyes)from February 2015 to February 2016 in our hospital were enrolled. The patients were randomly divided into two groups. Thirty-four patients(46 eyes)in Group A: coaxial 2.5mm incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation. Thirty-six patients(46 eyes)in Group B: the conventional coaxial 3.0mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time(BUT), Schirmer's Ⅰ test(SⅠt)and lid-parallel conjunctival folds(LIPCOF)were assessed preoperatively and postoperatively.

RESULTS: At 1wk, 1 and 3mo postoperatively, the BUT in two groups decreased after operations, and the BUT of Group B was significantly lower than those of Group A, the differences were statistically significant(t=3.089, 4.497, 4.322; all P<0.05). The SⅠt in two groups increased after operations, the SⅠt of Group B was significantly higher than those of Group A and the differences were statistically significant(t=-6.286, -3.992, -3.278; all P<0.05). The LIPCOF score in two groups increased after operations, the LIPCOF score of Group B was significantly higher than those of Group A and the differences were statistically significant(t=-6.552, -5.131, -3.652; all P<0.05). At 6mo postoperatively, compared with the preoperative data, the BUT, SⅠt and LIPCOF score in Group A showed no statistically significant differences(t=0.646, 0.551, 0.165; P>0.05). The BUT, SⅠt and LIPCOF score in Group B showed statistically significant differences(t=-4.059, 3.629, 4.211; all P<0.05).

CONCLUSION: Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.5mm incision phacoemulsmcation, compared with the conventional coaxial 3.0mm incision phacoemulsification surgery.