Dry eye after cataract surgery and associated intraoperative risk factors.
Dry eye after cataract surgery and associated intraoperative risk factors.
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DOI：
10.3341/kjo.2009.23.2.65
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发表时间：
2009-06
影响因子：
--
通讯作者：
Kim MS
中科院分区：
文献类型：
--
作者：
Cho YK;Kim MS
研究白内障手术后干眼症症状和诊断测试值的变化，并解决可能影响这些症状和测试结果的因素。对14例术前有干眼症患者的28只眼（干眼症组）和35例术前无干眼症患者的70只眼（非干眼症组）进行前瞻性研究。在每组中，我们测量了诸如泪膜破裂时间（tBUT）、Schirmer I试验（ST-I）、泪半月板高度（TMH）和主观干眼症状（Sx）等值，并评估了这些值的术后变化。我们还评估了角膜切口位置和形状对这些值的影响。研究了这些值与显微镜曝光时间和超声乳化能量之间的相关性。与术前相比，干眼组术后2个月Sx和术后3天、10天、1个月和2个月TMH均显著加重。在非干眼症组中，所有干眼症测试值在白内障手术后显著恶化。关于切口位置，在任何术后时间点，干眼组或非干眼组的tBUT、Sx、ST-I或TMH均无差异。关于切口形状，干眼组在任何术后时间点的tBUT、Sx、ST-I或TMH均无差异。在非干眼组的上级切口亚组中，第1天沟槽切口组的tBUT和Sx更差。在非干眼组的颞侧切口亚组中，沟槽切口组在术后1d、3d和10 d的Sx更差。在两组中，显微镜下曝光时间与干眼测试值之间存在显著相关性，但超声乳化能量与干眼测试值之间没有相关性。白内障手术可能导致干眼症。术前无干眼症的患者，术后早期行沟槽切口可加重症状。长的显微镜光暴露时间可对干眼测试值产生不利影响。
To investigate changes in dry eye symptoms and diagnostic test values after cataract surgery and to address factors that might influence those symptoms and test results. Twenty-eight eyes from 14 patients with preoperative dry eye (dry eye group) and 70 eyes from 35 patients without preoperative dry eye (non-dry eye group) were studied prospectively. In each group, we measured values such as tear break-up time (tBUT), Schirmer I test (ST-I), tear meniscus height (TMH), and subjective dry eye symptoms (Sx), and evaluated the postoperative changes in these values. We also evaluated the influence of corneal incision location and shape on these values. The correlations between these values and microscopic light exposure time and phacoemulsification energy were investigated. In the dry eye group, there were significant aggravations in Sx at 2 months postoperatively and in TMH at 3 days, 10 days, 1 month, and 2 months postoperatively, compared with preoperative values. All dry eye test values were significantly worse after cataract surgery in the non-dry eye group. With regard to incision location, there was no difference in tBUT, Sx, ST-I, or TMH in either the dry eye group or the non-dry eye group at any postoperative time point. Regarding incision shape, there was no difference in tBUT, Sx, ST-I or TMH at any postoperative time point in the dry eye group. In the superior incision sub-group of the non-dry eye group, tBUT and Sx were worse in the grooved incision group at day 1. In the temporal incision sub-group of the non-dry eye group, Sx were worse in the grooved incision group at 1 day, 3 days, and 10 days postoperatively. In both groups, significant correlations were noted between microscopic light exposure time and dry eye test values, but no correlation was noted between phacoemulsification energy and dry eye test values. Cataract surgery may lead to dry eye. A grooved incision can aggravate the symptoms during the early postoperative period in patients without dry eye preoperatively. Long microscopic light exposure times can have an adverse effect on dry eye test values.