CAJ | 학술논문

目的探讨年龄相关性白内障在表面麻醉下不同方位手术切口的超声乳化白内障抽吸联合后房型人工晶状体植入术后眼部的观察.方法 68例(78只眼)均在表麻下行上方或水平方位透明角膜缘切口的白内障超声乳化联合后房型人工晶状体植入术,术后根据切口位置归为两组:上方透明角膜缘切口组31例(41只眼),水平透明角膜缘切口组31例(37只眼).每组均在术前和术后1周,1个月,3个月时行泪膜破裂时间(BUT),泪液分泌实验Ⅰ(SchirmerⅠ)和角膜荧光素实验指标的眼部观察.结果所有入选的病例均在表麻下接受手术治疗,术后随访3个月.两组在视力,年龄,结膜充血,房水闪辉差异无统计学意义(P＞0.05).上方透明角膜缘切口组和水平组之间在泪膜破裂时间(BUT)及泪液分泌实验Ⅰ(SchirmerⅠ)在各个观察时间点差异均有统计学意义(P＜0.05),而角膜切口局部染色(FL)在同一时间点则差异无统计学意义(P＞0.05).每组均显示在术后1周时各项指标与术前差异有统计学意义(P＜0.05).上方透明角膜缘切口组在术后3个月除SchirmerⅠ外,另两项指标基本恢复至术前水平.在水平透明角膜缘切口同一时间点BUT,SchirmerⅠ仍未基本恢复至术前水平.结论白内障超声乳化抽吸联合后房型人工晶状体植入术后水平透明角膜缘切口可能比上方透明角膜缘切口更容易出现类似干眼症状,且相关指标异常出现的高峰期在术后1周左右.
목적 탐토년령상관성백내장재표면마취하불동방위수술절구적초성유화백내장추흡연합후방형인공정상체식입술후안부적관찰.방법 68례(78지안)균재표마하행상방혹수평방위투명각막연절구적백내장초성유화연합후방형인공정상체식입술,술후근거절구위치귀위량조:상방투명각막연절구조31례(41지안),수평투명각막연절구조31례(37지안).매조균재술전화술후1주,1개월,3개월시행루막파렬시간(BUT),루액분비실험Ⅰ(SchirmerⅠ)화각막형광소실험지표적안부관찰.결과 소유입선적병례균재표마하접수수술치료,술후수방3개월.량조재시력,년령,결막충혈,방수섬휘차이무통계학의의(P＞0.05).상방투명각막연절구조화수평조지간재루막파렬시간(BUT)급루액분비실험Ⅰ(SchirmerⅠ)재각개관찰시간점차이균유통계학의의(P＜0.05),이각막절구국부염색(FL)재동일시간점칙차이무통계학의의(P＞0.05).매조균현시재술후1주시각항지표여술전차이유통계학의의(P＜0.05).상방투명각막연절구조재술후3개월제SchirmerⅠ외,령량항지표기본회복지술전수평.재수평투명각막연절구동일시간점BUT,SchirmerⅠ잉미기본회복지술전수평.결론 백내장초성유화추흡연합후방형인공정상체식입술후수평투명각막연절구가능비상방투명각막연절구경용역출현유사간안증상,차상관지표이상출현적고봉기재술후1주좌우.
Objective To investigate ocular surface in patients after Phacoemulsification with different direction of clear cornea incisions. Methods A total of 62 patients (78 eyes) were divided into two groups:one group was through a clear corneal incision at margin level,the other was through a clear corneal incision above margin.In each group,the values such as subjective dry eye symptoms (Sx),tear break-up time (tBUT),Schirmer Ⅰ test (ST-Ⅰ),and cornea incisions fluorescein staining (FL) were measured before Phacoemulsification and 1 week,1 month and 3 months after surgery. Results All the operations were achieved in the surface anesthesia.Two groups was no statistical significance in vision,age,conjunctival congestion and aqueous flare (P ＞0.05).Two groups was statistical significance in tear break-up time (tBUT),Schirmer Ⅰ test (ST-Ⅰ) (P ＜0.05),but in cornea incisions fluorescein staining (FL) had no statistical significance (P ＞0.05).The three values were obvious changes in each group after surgery 1 week compared with the preoperative.The group in a clear comeal incision above margin,at 3 months of post-operation,the fluorescein staining (FL) and tear break-up time (tBUT) was basically equal to the level of pre-operation.But the group in a clear corneal incision margin level was also less than preoperation. Conclusions Phacoemulsification through a clear corneal incision margin level is more likely to have similar dry eye symptoms than through a clear corneal incision above margin,and also those related values abnormal appear in the early time on 1 week after operation.