方法：我院2010-03/2011-09收治的有青光眼药物用药史的青光眼白内障联合手术患者26例29眼，测定患者与健康者各时期泪液MUC5AC含量及眼表功能评分，分析患者与健康者各时期泪液MUC5AC含量及眼表功能评分差异，分析用药时间和联合用药种类与患者手术前后眼表功能评分相关性，比较手术前后患者泪液MUC5AC含量及眼表功能评分变化。

结果：青光眼患者各时期泪液MUC5AC含量明显低于健康者，两者术前1d(健康者第1d)，术后1，3mo(健康者第1，3mo)相比有统计学意义(P=0.0168，P=0.0001，P=0.0150)，两者术后6mo(健康者第6mo)相比无统计学意义(P=0.2230)； 青光眼患者术后泪液MUC5AC含量明显降低，此后逐渐上升，患者术后1mo泪液MUC5AC含量与术前1d，术后3，6mo比较有统计学意义(P=0.0365，P=0.0329，P=0.0004)； 患者术前眼表功能评分与用药时间和联合用药种类呈正相关关系(P=0.0427，P=0.0327)，术后6mo眼表功能评分与用药时间和用药种类无相关性(P=0.1788，P=0.9916)； 青光眼患者术后眼表功能评分明显升高，此后逐渐降低，患者术后1mo眼表功能评分与术前1d，术后3，6mo比较有统计学意义(P=0.0012，P=0.0001，P=0.0000)，患者术后6mo眼表功能评分明显降低，与术前1d相比较有统计学意义(P=0.0049)。

结论：青光眼药物和青光眼联合白内障手术均损害患者泪液MUC5AC及眼表，这种损害随患者用药时间和联合用药种类的增加而更加明显，随术后时间的延长而逐渐改善。

METHODS: Totally 26 cases(29 eyes)underwent glaucoma and cataract surgery who with history of glaucoma drugs admitted to our hospital in March 2010 to September 2011 were included. The content of tear MUC5AC and the ocular surface function scores of patients and healthy people at different time point were measured and analyzed. The relativity between types and taking time of medication, and ocular surface function scores before and after surgery was analyzed. The change of ocular surface function score, and the content of tear MUC5AC before and after surgery was compared.

RESULTS: Content of tear MUC5AC of glaucoma patients at each period was significantly lower than that of healthy people. There was statistically significance at preoperative 1 day, postoperative 1 month, 3 months(P=0.0168,P=0.0001,P=0.0150), and there was no statistically significance postoperative 6 months(P=0.2230). The content of tear MUC5AC of glaucoma patients decreased significantly post-operation, then gradually increased. Comparing the content of tear MUC5AC 1 month post-operation with 1 day pre-operation, 3 months and 6 months post-operation, there was statistically significance(P=0.0365,P=0.0329,P=0.0004). There was a positive correlation between preoperative ocular surface function score and the taking time and types of medication(P=0.0427,P=0.0327), and there was no correlation 6 months post-operation(P=0.1788,P=0.9916). The ocular surface function score of glaucoma patients was significantly higher, then gradually reduced, there was statistically significance between 1 month post-operation and 1 day pre-operation, 3 months and 6 months post-operation(P=0.0012,P=0.0001,P=0.0000). Ocular surface function score was significantly lower 6 months post-operation, compared with the preoperative 1 day, there was statistically significance(P=0.0049).

CONCLUSION: Glaucoma medications combined with glaucoma and cataract surgery impaired tear MUC5AC and ocular surface, such kind of damage is more obvious with the increase of taking time and types of the drug and gradually improves with the post-operative time extending.