白内障术中应用粘弹剂对糖尿病患者角膜上皮保护的临床观察

摘要

Objective To observe the clinical effect of using viscoelastic agent to protect corneal epithelium and prevent corneal epithelial dysfunction after cataract surgery. Methods 74 patients(n=74)with diabetic cataract from January 2014 to Oc-tober 2015 in our hospitalwere randomly selected and divided into experimental group(n=37)and control group(n=37). Phacoe-mulsification and intraocular lens implantation were performed in all patients with diabetic cataract under surface anesthesia. The experimental group was treated with viscoelastic agent to protect the corneal epithelium,while the control group was treated with phacoemulsification and intraocular lens implantation. Before and 3d、1w、1mon after surgery,the tear film break-up time(BUT),cor-neal fluorescein staining and subjective symptom score of the two groups were observed. Results 3d and 1w after surgery,BUT in the experimental group was higher than that in the control group,and the corneal fluorescein staining was better than that in the control group,the difference between the two groups was statistically significant(P<0. 05). There was no significant difference between the two groups in corneal epithelial recovery,BUT and corneal fluorescein staining 1mon after surgery(P>0. 05). Conclusion The ap-plication of viscoelastic agent in phacoemulsification and intraocular lens implantation in diabetic cataract can protect the corneal epi-thelium,reduce postoperative corneal epithelial dysfunction caused by eye irritation,with good effects,worthy of clinical application.%目的 观察糖尿病患者白内障术中应用粘弹剂保护角膜上皮,预防术后发生角膜上皮功能障碍的临床疗效.方法 随机选取2014年1月至2015年10月期间在我院眼科收治的74例(74眼)糖尿病性白内障患者,随机分为试验组37例(37眼)和对照组37例(37眼),所有糖尿病性白内障患者均在表麻下行超声乳化联合人工晶体植入术,试验组术中应用粘弹剂保护角膜上皮,对照组常规行超声乳化联合人工晶体植入术.观察术前、术后3d、1周、1个月两组患者泪膜破裂时间(BUT),角膜荧光素钠染色情况,自觉症状评分.结果 术后3d、1周试验组BUT高于对照组,角膜荧光素钠染色情况好于对照组,两组差异有统计学意义(P<0.05),1个月两组角膜上皮恢复,BUT及角膜荧光素钠染色比较,差异无统计学意义(P>0.05).结论 在糖尿病性白内障超声乳化并人工晶状体植人术中,应用粘弹剂能保护角膜上皮,减轻术后角膜上皮功能障碍引发的眼部刺激症状,效果良好,值得临床推广应用.