不同类型药物对干眼症患者超声乳化术后眼表修复的比较

目的:探讨干眼症患者白内障超声乳化术后泪膜稳定性及睑板腺功能的变化,比较小牛血去蛋白提取物眼用凝胶、玻璃酸钠滴眼液和维生素A棕榈酸酯眼用凝胶在干眼患者白内障超声乳化术后治疗的疗效和差异.方法:选取2015-02/08行白内障超声乳化联合人工晶状体植入术的干眼患者90例90眼,随机分为小牛血去蛋白提取物眼用凝胶组(A组)、玻璃酸钠滴眼液组(B组)和维生素A棕榈酸酯眼用凝胶组(C组),每组30例30眼.分别于术前,术后7、30、90d进行干眼问卷调查(OSDI)、泪膜破裂时间检查(BUT)、角膜荧光染色(FL)、泪液分泌试验(SⅠt)、睑板腺照相.结果:三组各项检查值在术前无统计学差异(P>0.05),组内各项检查术前与术后7、30、90d比较,除睑板腺评分,差异无统计学意义(P>0.05),其他各项检查差异均有统计学意义(P<0.05).术后7d,各组SⅠt、BUT检查低于术前,FL、OSDI评分高于术前差异均有统计学意义(P<0.05) ,各组间差异无统计学意义(P>0.05).术后30d,SⅠt、BUT及OSDI评分结果A、C组优于B组,差异有统计学意义(P<0.05),FL检查结果A组优于B、C组,差异有统计学意义(P<0.05),术后30、90d,三组SⅠt、BUT、FL、OSDI评分均较术前均有不同程度改善,差异有统计学意义(P<0.05),术后90d,三组各项检查结果两两比较差异无统计学意义(P>0.05).结论:超声乳化手术会影响干眼患者泪膜稳定性及睑板腺功能,局部应用小牛血眼用凝胶、玻璃酸钠滴眼液和维生素A棕榈酸酯眼用凝胶均可改善干眼患者的症状.小牛血去蛋白提取物眼用凝胶和维生素A棕榈酸酯眼用凝胶在延长BUT方面优于玻璃酸钠,小牛血去蛋白提取物眼用凝胶修复角膜上皮方面更具优势.

Effect of different drugs for ocular surface healing in patients with preoperative dry eye after phacoemulsification

AIM:To evaluate changes in tear film stability and meibomian gland function and the clinic efficacy of three different artificial tears in patients with preoperative dry eye after phacoemulsification.METHODS:All 90 cataract patients (90 eyes) with preoperative dry eye who underwent phacoemulsification randomly divided into three groups (Group A treated with protein-free calf blood extract ophthalmic gel;Group B treated with sodium hyaluronate eye drops;Group C treated with Vitamin A palmitate eye gel).Ocular Surface Disease Index (OSDI), Schimer's I test(SⅠt), tear film break time (BUT), corneal fluorescein staining (FL) and meibography were performed for all patients preoperatively and 7, 30 and 90d postoperatively.RESULTS:No statistical differences existed among the three preoperative groups (P>0.05).Except meibomian gland score, there was no statistical significance among preoperatively and 7, 30, 90d postoperatively of the three groups (P>0.05).At 7d postoperatively, SⅠt and BUT of every group were lower than those before treatment, FL scores and OSDI scores were higher than those preoperative (P<0.05);there were no statistical differences among the three groups(P>0.05).At 30d postoperatively, SIt, BUT, OSDI scores in group A and C were better than in group B, which displayed statistical differences (P<0.05);FL scores in group A were significantly better than in group B and C (P<0.05).At 30, 90d postoperatively, SIt, BUT, FL scores, OSDI scores were better than preoperative results, which displayed statistical differences (P<0.05).There were no statistical differences among the three groups at 90d postoperatively (P>0.05).CONCLUSION:Tear film stability and meibomian gland function were affected by phacoemulsification.Topical application of deproteinised calf blood extract eye gel, sodium hyaluronate eye drops and Vitamin A palmitate eye gel all hase a clearly beneficial effect on subjective symptoms.Deproteinised calf blood extract eye gel and Vitamin A Palmitate Eye Gel had more powerful effect on BUT than sodium hyaluronate, however deproteinised calf blood extract eye gel is more effective in superficial punctuate keratopathy.