目的:比较小切口手法碎核白内障摘除术与超声乳化白内障摘除术两种不同手术切口对角膜知觉以及泪液分泌功能的影响。方法:随机抽取行小切口手法碎核白内障摘除术和超声乳化白内障摘除术的年龄相关性白内障患者各30例30眼,分别于术前,术后1d;1wk;1,3mo行角膜知觉测量和泪液分泌试验,用日本HANDAYA角膜知觉计分别测量角膜中央、上方、下方、鼻侧、颞侧的角膜知觉阈值(以测定器的尼龙丝长度表示),用天津晶明泪液分泌试纸测量术前,术后1d;1wk;1,3mo患者的泪液分泌量。结果:术后1d两组患者各点角膜知觉显著下降,小切口手法碎核组角膜知觉以颞侧和中央下降最为明显,减退值分别为26%,24%;其次是上方、鼻侧和下方,分别减少:19%,14%,14%。术后3mo上方、下方、鼻侧的角膜知觉基本恢复到术前水平。超声乳化组上方角膜知觉下降最为明显,减少47%。术后1wk;1mo各点角膜知觉均有所恢复,术后3mo除了下方外,各点角膜知觉均未恢复到术前水平。两组患者术后1d泪液分泌量均增加,术后1wk泪液分泌逐渐减少,术后3mo泪液分泌量略低于术前水平。结论:与超声乳化白内障摘除术相比,小切口手法碎核白内障摘除术对患者角膜知觉影响较小,术后角膜知觉恢复较快;两种手术方法均对患者泪液分泌功能产生影响,但术后恢复较快。

AIM:To observe the influences of different incision methods——manual small-incision cataract surgery(manual SICS)and phacoemulsification on corneal sensation and tear secretion.·METHODS:This was a prospective randomized study involved 60 cases with age-related cataract(ARC)undergoing manual SICS or phacoemulsification.Corneal sensitivity was assessed preoperatively and at postoperative day 1,week 1,month 1,3 using the HANDAYA(Japan) esthesiometer at five locations:centrally,superiorly,inferiorly,nasally and temporally(all sensitivity data were transformed in nylon thread lengths).Schirmer test results were evaluated preoperatively and at postoperative day 1,week 1,month 1 and 3 with Schirmer test trips(Tianjin Jinming).·RESULTS:The corneal sensation reduced greatly at 1 day postoperatively in both groups.In the group undergoing manual SICS,corneal sensitivity decreased obviously at the temporal and central site,reduced by 26%,24% respectively,and 19%,14%,14% on the superior,nasal,inferior site. At 3 month postoperatively,corneal sensitivity recoverd to presurgery level at the surperior,inferior,nasal site. In the group undergoing phacoemulsification,corneal sensitivity decreased sharply at surperior site,reduced by 47%.Coneal sensitivity on every site recovered at 1 week and 1 month postoperatively. Except inferior site,at 3 month postoperatively corneal sensitivity on the other sites didn’t recover to presurgery level.Tear production significantly increased on the first day in both groups,decreased gradually at 1 week postoperatively,and at 3 month postoperatively tear production was less than preoperatively.·CONCLUSION:Compared with phacoemulsification,manual SICS has less influence on corneal sensitivity,and recover quickly after surgery. Patient’s tear secretion function has been effected after two kinds of surgery,but recover rapidly after surgery.

R779.6