Investigation of dry eye disease and analysis of the pathogenic factors in patients after cataract surgery
Investigation of dry eye disease and analysis of the pathogenic factors in patients after cataract surgery
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DOI：
10.1097/ico.0b013e31812f67ca
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发表时间：
2007-10-01
期刊：
影响因子：
2.8
通讯作者：
Wang, Wei
中科院分区：
文献类型：
--
作者：
Li, Xue-Min;Hu, Lizhong;Wang, Wei
目的：目的：探讨白内障术后干眼症的发病原因，为探讨干眼症的发病机制，对37例（50眼）白内障患者在术前3 d、术后1周、1个月、3个月分别进行25项美国国立眼科研究所视觉功能问卷（NEI-VEGF 25）和眼表疾病指数（OSDI）的调查。同时行裂隙灯显微镜检查、角膜和结膜荧光素染色、泪膜破裂时间（BUT）、Schirmer试验1（STI）和印模细胞学（IC）检查。从地球仪结膜的上眼睑覆盖区域、爆裂区域和下眼睑覆盖区域获得IC的细胞学标本。结果：白内障术后干眼症的发病率明显增加，NEI-VEGF 25和OSDI均提示大多数患者术后出现干眼症。白内障术后患者泪管线变窄，泪管破裂时间、泪管收缩时间缩短。IC提示地球仪结膜上皮层存在严重的鳞状上皮化生，尤其是下睑区。结论：白内障术后如不及时治疗，干眼症可发展或恶化。眼药水滥用是白内障术后干眼症的主要致病因素之一。白内障手术前后应谨慎滴眼液，以避免或减少术后干眼症的发生。
Purpose: To study dry eye and analyze pathogenic factors in patients after cataract surgery.Methods: A total of 37 patients (50 eyes) were studied by using a 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ25) and Ocular Surface Disease Index (OSDI) 3 days before and 1 week, 1 month, and 3 months after cataract surgery. Slit-lamp microscope examination, cornea and conjunctiva fluorescein staining, tear breakup time (BUT), Schirmer test 1 (STI), and impression cytology (IC) were carried out at the same time. Cytologic specimens for IC were obtained from the upper lid-covered region, explosive region, and lower lid-covered region of the globe conjunctiva. The average density of goblet cells on these 3 regions was measured, and the pathogenic factors of dry eye after cataract surgery were analyzed.Results: After cataract surgery, the incidence of dry eye increased dramatically; NEI-VFQ25 and OSDI indicated that most patients developed this symptom after surgery. The lacrimal river line became narrow, and BUT and STI decreased in patients after cataract surgery. IC suggested the presence of serious squamous metaplasia in the epithelial layer of the globe conjunctiva, especially the lower lid region.Conclusions: Dry eye can develop or deteriorate after cataract surgery if not treated in time. Misuse of eyedrops is one of the major pathogenic factors that causes dry eye after cataract surgery. Eyedrops should be carefully administered before and after cataract surgery to avoid or reduce the occurrence of dry eye postoperatively.