飞秒激光辅助白内障超声乳化术后眼表微环境变化

发布时间：2018-04-12 13:44

本文选题：白内障 + 飞秒激光　；参考：《山东医药》2017年36期

【摘要】：目的探讨行飞秒激光辅助白内障超声乳化术的白内障患者术后眼表微环境变化。方法选择白内障患者143例,根据患者意愿分为传统超声乳化组73例(86眼)、飞秒激光辅助组70例(86眼)。传统超声乳化组采用传统白内障超声乳化吸除联合人工晶状体植入术,飞秒激光辅助组在飞秒激光手术系统辅助下完成白内障超声乳化吸除联合人工晶状体植入术。两组分别于术前及术后1、7、14、30、60天采用Oculus眼表综合分析仪检测非侵入性泪膜破裂时间(NIBUT)、下泪河高度(LTMH)、干眼分级。结果与同组术前比较,两组术后1天NIBUT明显缩短,LTMH明显增大,干眼分级明显增加(P均0.05)。飞秒激光辅助组术后7天NIBUT虽长于术后1天,但仍短于术前(P0.05),术后14、30、60天趋于稳定,较术后1、7天明显延长(P均0.05),而与术前比较差异无统计学意义(P0.05);术后7、14、30、60天LTMH、干眼分级趋于稳定,较术后1天明显降低(P均0.05),而与术前比较差异无统计学意义(P0.05)。传统超声乳化组术后7、14天NIBUT明显长于术后1天,干眼分级大于术后1天,但与术前比较仍有统计学差异(P均0.05);术后30、60天NIBUT、干眼分级趋于稳定,NIBUT较术后1、7、14天明显延长(P均0.05),而干眼分级较术后1、7、14天明显降低(P均0.05),但二者术后30、60天与术前比较差异无统计学意义(P均0.05);术后7天LTMH仍高于术前(P0.05),但与术后1天比较差异无统计学意义(P0.05),术后14、30、60天LTMH趋于稳定,较术后1、7天明显降低(P均0.05),与术前比较差异无统计学意义(P均0.05)。结论行飞秒激光辅助白内障超声乳化术的白内障患者术后眼表微环境变化较小,术后14天左右泪膜稳定性即可恢复至术前水平。
[Abstract]:Objective to investigate the changes of ocular surface microenvironment in cataract patients undergoing femtosecond laser assisted phacoemulsification.Methods 143 patients with cataract were divided into traditional phacoemulsification group (73 cases, 86 eyes) and femtosecond laser assisted group (70 cases, 86 eyes).Traditional phacoemulsification combined with intraocular lens implantation and femtosecond laser assisted cataract phacoemulsification combined with intraocular lens implantation were performed in the traditional phacoemulsification group.The time of noninvasive lacrimal film rupture (NIBUTT), the height of lower lacrimal river and the grade of dry eye were detected by Oculus ocular surface comprehensive analyzer before operation and 30 days after operation.Results compared with the same group before operation, the NIBUT was significantly shortened and the dry eye grade was significantly increased in both groups on the 1st day after operation (P < 0.05).Compared with the postoperative day, the P was significantly lower than that before operation (P 0.05), but there was no significant difference between the two groups before and after operation (P 0.05).In the traditional phacoemulsification group, the NIBUT was significantly longer than that on the 1st day after operation, and the dry eye grade was larger than that on the 1st day after operation.However, there was still a significant difference between before and after operation (P < 0.05), and 30 days after operation, NIBUTT tended to be stable and NIBUT was significantly longer than that of 1 day and 7 days after operation (P < 0.05), while dry eye grading was significantly lower than that of postoperative day 1, 714 (P < 0.05), but the ratio between the two groups was 3060 days after operation and 0.05 before operation.There was no significant difference between the two groups (P < 0.05), LTMH was still higher at 7 days after operation than that before operation (P 0.05), but there was no significant difference compared with 1 day after operation (P 0.05). The LTMH tended to be stable at 1430 ~ 60 days after operation.There was no significant difference between the two groups on the 1st and 7th day after operation, and there was no significant difference between the two groups (P < 0.05).Conclusion the change of microenvironment in cataract patients after femtosecond laser assisted phacoemulsification is relatively small, and the stability of tear film can be restored to the preoperative level about 14 days after operation.
【作者单位】：潍坊眼科医院国家临床重点专科建设项目单位;
【分类号】：R779.66

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