透明角膜隧道切口超声乳化摘除术治疗白内障的疗效及对SDES评分和BUT的影响

Curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on dry eye symptom scores and break-up time

摘要:

目的：分析透明角膜隧道切口超声乳化摘除术治疗白内障的疗效及对患者主观干眼症状问卷评分(SDES)和泪膜破裂时间(BUT)的影响。

方法：选取2015-06/2019-01在本院接受白内障手术的117例139眼白内障患者，按随机数字表法分为A组(65例72眼)、B组(52例67眼)； 两组均接受超声乳化摘除术，A组使用2.2mm微切口，B组使用3.0mm切口； 比较两组一般手术情况、SDES、BUT及疗效指标\〖最佳矫正视力(BCVA)、等效球镜(SE)和角膜内皮细胞密度(ECD)\〗。

结果：两组超声时间、累计释放能量、手术时间及术后并发症无差异(P>0.05)； 术后两组干眼症状评分较术前显著上升，BUT较术前1d有下降趋势，至术后3mo时SDES评分、BUT恢复至术前水平； 但A组术后1d，1wk时的干眼评分显著低于B组，BUT显著高于B组(P<0.05)； 且两组术后BCVA(LogMAR)、ECD、SE较术前均显著下降，但组间无差异(P>0.05)。

结论：透明角膜切口白内障超声乳化摘除术治疗白内障疗效可靠，且2.2mm微切口术后泪膜功能更佳。

Abstract:

AIM:To analyze curative effect of phacoemulsification through clear corneal tunnel incision on cataract and the influences on subjective sylptols of dry eye questionnaire scores(SDES)and break-up time(BUT).

METHODS: During the period from June 2015 to January 2019, 117 cataract patients(139 eyes)who underwent cataract surgery in the hospital were divided into group A(n=65, 72 eyes)and group B(n=52, 67 eyes)by random number table method. Groups A and B underwent phacoemulsification through 2.2mm and 3.0mm micro-incision, respectively. The general surgical status, SDES, BUT and curative effect indexes \〖best corrected visual acuity(BCVA), spherical equivalent(SE), endothelial cell density(ECD)\〗 were compared between the two groups.

RESULTS: There was no significant difference in ultrasound time, cumulative released energy, operation time or postoperative complications between two groups(P>0.05). After surgery, SDES scores in both groups were significantly increased, BUT was decreased compared with that at 1d before surgery. At 3mo after surgery, SDES and BUT recovered to preoperative levels. At 1d and 1wk after surgery, SDES score in group A was significantly lower than that in group B, while BUT was significantly higher than that in group B(P<0.05). After surgery, BCVA LogMAR and ECD in both groups were significantly decreased, while SE and corneal diopter were significantly increased, without significant difference between the two groups(P>0.05).

CONCLUSION:The curative effect of phacoemulsification through clear corneal tunnel incision is reliable on cataract. The tear film function is better through 2.2mm micro-incision.