山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (6): 68-70.doi: 10.6040/j.issn.1673-3770.0.2015.201

• 论著 • 上一篇    下一篇

白内障超声乳化摘除手术对睑板腺功能的影响

刘钊, 吴昌睿, 高宁   

  1. 西安交通大学第一附属医院眼科, 陕西 西安 710061
  • 收稿日期:2015-05-25 出版日期:2015-12-16 发布日期:2015-12-16
  • 通讯作者: 高宁. E-mail:gaoning@mail.xjtu.edu.cn E-mail:gaoning@mail.xjtu.edu.cn
  • 作者简介:刘钊. E-mail:drliuzhao@foxmail.com

Evaluation of meibomian gland dysfunction after phacoemulsification surgery

LIU Zhao, WU Changrui, GAO Ning   

  1. Department of Ophthalmology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China
  • Received:2015-05-25 Online:2015-12-16 Published:2015-12-16

摘要: 目的 评估白内障超声乳化摘除手术对睑板腺功能的影响.方法 对拟接受白内障超声乳化摘除术的58例(58眼)于术前、术后1个月、术后3个月分别完成OSDI、睑缘形态评分、泪膜破裂时间、角膜上皮荧光素染色、泪河检查、睑板腺脂质分泌、泪液分泌功能等检查.结果 相比术前,术后患眼的OSDI评分明显上升,睑缘形态明显变差.相比术前,睑板腺脂质分泌在术后1个月时无变化,而3个月时明显变差.术后BUT一直在下降.但是,角膜上皮点状染色、泪液分泌功能以及泪河术后未见明显改变.结论 白内障手术可以诱发或加重睑板腺功能障碍.

关键词: 白内障, 白内障超声乳化摘除手术, 睑板腺功能障碍

Abstract: Objective To evaluate meibomian gland dysfunction after phacoemulsification surgery. Methods Fifty-eight eyes of 58 patients underwent phacoemulsification and were evaluated the OSDI, lid margin abnormalities, superficial punctate keratopathies (SPK), tear film break-up time (BUT), Schirmer test, lower tear meniscus height, depth, and area using anterior segment optical coherence tomography, and meibum expressibility pre-operatively and at 1 month and 3 months post-operatively. Results The OSDI were worse at 1 month and 3 months post-operatively (10.7±7.9, 25.7±7.9, 27.9±12.1, P<0.05 and P<0.05, respectively). Lid margin abnormalities were significantly increased (1.6±1.0, 2.0±1.2, 2.5±0.9, P<0.05 and P<0.05, respectively) and BUT decreased post-operatively (6.6±3.1, 4.3±1.9, 4.1±2.2, P<0.05 and P<0.05, respectively). Meibum expressibility decreased at 3 months post-operatively (1.8±0.9 vs 2.2±0.7, P<0.05); however, SPK, lower tear meniscus height, depth and area and the Schirmer test did not significantly change post-operatively (P>0.05). Conclusion Meibomian gland function may be altered without accompanying structural changes after phacoemulsification surgery.

Key words: Cataract, Meibomian gland dysfunction, Phacoemulsification

中图分类号: 

  • R777.1+3
[1] Oh T, Jung Y, Chang D, et al. Changes in the tear film and ocular surface after cataract surgery[J]. Jpn J Ophthalmol, 2012, 56(2):113-118.
[2] Nelson J D, Shimazaki J, Benitez-del-Castillo J M, et al. The international workshop on meibomian gland dysfunction: report of the definition and classification subcommittee[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):1930-1937.
[3] Knop E, Knop N, Millar T, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on anatomy, physiology, and pathophysiology of the meibomian gland[J]. Invest Ophthalmol Vis Sci, 2011, 52(4):1938-1978.
[4] Levinson B A, Rapuano C J, Cohen E J, et al. Referrals to the Wills Eye Institute Cornea Service after laser in situ keratomileusis: reasons for patient dissatisfaction[J]. J Cataract Refract Surg, 2008, 34(1):32-39.
[5] Shimazaki J I, Sakata M, Tsubota K. Ocular surface changes and discomfort in patients with meibomian gland dysfunction[J]. Arch Ophthalmol, 1995, 113(10):1266-1270.
[6] 房修岭, 姜虎林, 吴建霞, 等. 0.5%聚维酮碘冲洗结膜囊预防白内障术后眼内炎[J]. 山东大学耳鼻喉眼学报, 2014, 28(5):66-68. FANG Xiuling, JIANG Hulin, WU Jianxia, et al. Pre-operative irrigation of conjunctival sac using 0.5% povidone iodine in preventing endophthalmitis after cataract surgery[J]. J Otolaryngol Ophthal Shangdong Univ, 2014, 28(5):66-68.
[7] Arita R, Itoh K, Maeda S, et al. Proposed diagnostic criteria for obstructive meibomian gland dysfunction[J]. Ophthalmology, 2009, 116(11):2058-2063. e1.
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