玻璃酸钠对白内障超声乳化联合IOL植入术后眼部炎症反应和干眼症的影响

摘要

目的:探讨玻璃酸钠滴眼液对年龄相关性白内障超声乳化联合IOL植入术后眼部炎症反应和干眼症的影响.方法:回顾性分析我院2016-06/2017-07择期行超声乳化联合IOL植入术治疗的年龄相关性白内障患者200例200眼的临床资料,根据术后应用滴眼液的不同分为观察组和对照组(各100例).观察组给予玻璃酸钠滴眼液,对照组给予妥布霉素地塞米松滴眼液.比较两组患者术前和术后第1、7、14d 时泪膜破裂时间(break-up time, BUT)、角膜荧光素染色(fluorescein staining,FL)评分、房水蛋白浓度检查结果及眼表疾病指数(ocular surface disease index,OSDI)评分,并分析术后1、14d时结膜充血和睫状充血发生率.结果:术前和术后1d时两组患者组间OSDI评分比较,差异均无统计学意义(P>0.05);术后1、7、14d时两组患者OSDI评分均高于术前,差异均有统计学意义(P0.05);术后1、7、14d时两组患者BUT均低于术前,差异均有统计学意义(P0.05);术后1、7、14d时两组患者FL与术前比较,差异均有统计学意义(P0.05);术后14d两组患者结膜充血、睫状充血发生率均低于术后1d,差异均有统计学意义(P0.05). The OSDI score of the two groups was higher than that before the operation on the first, the seventh and the fourteenth day after surgery (P0.05). The levels of BUT in the two groups were lower than those before operation on the first,the seventh and the fourteenth day after surgery (P 0.05). The levels of FL in the two groups were different from those before operation (P0.05); the incidence of conjunctival hyperemia and ciliary hyperemia in the two groups on the fourteenth day after surgery was lower than that on the first day after surgery (P<0.05). However, the incidence of conjunctival hyperemia and ciliary congestion on the fourteenth day after operation was significantly lower in the control group than in the observation group (P<0.05). Postoperatively 1,7,14d, aqueous humor protein concentration in the two groups of patients compared with preoperative had difference (P< 0. 05), and two groups of patients with aqueous humor at postoperatively 1d after reaching the highest protein concentration decreased ( P < 0. 05 ), aqueous humor protein concentrations of the control group 7,14d after operation were lower than the observation group (P<0.05). ·CONCLUSION: The effect of sodium hyaluronate eye drops on improving dry eye after age-related cataract phacoemulsification combined with IOL implantation is greater than that of tobramycin dexamethasone eye drops, but it is less effective for eye inflammation than tobramycin dexamethasone eye drops.After comprehensive consideration, for the patients with light inflammation, small incision phacoemulsification combined with IOL implant, sodium hyaluronate eye drops is a good selection.