方法：选取64例76眼的非干眼患者，对其行白内障超声乳化吸除术。随机分为两组：A组30例38眼，行2.5mm同轴小切口白内障超声乳化术； B组34例38眼，行1.8mm以下双轴微切口白内障超声乳化术(MICS)。分别于术前，术后1wk； 1，3，6mo； 1a对患者行基础泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色(CFS)和泪膜渗透压检查。采用SPSS 19.0 统计软件，对数据进行卡方检验和配对t检验分析。

结果：(1)SⅠt试验：A组和B组在术后1wk时明显增加，其差异具有统计学意义(P<0.01)，而其他各时间点差异均无统计学意义(P>0.05)；(2)BUT：A组和B组在术后1wk； 1，3mo时明显缩短，其差异具有统计学意义(P<0.05)，其余各点差异均无统计学意义(P>0.05)；(3)CFS评分：A组和B组在术后1wk； 1，3mo时增加，其差异均有统计学意义(P<0.05)，其余各点差异无统计学意义(P>0.05)；(4)泪液渗透压：A组和B组术后1wk和1mo时明显增高，其差异有统计学意义(P<0.01)，其余各点均无统计学意义(P>0.05)。

结论：术后早期，行1.8mm以下双轴微切口白内障超声乳化术(MICS)对泪膜稳定性的影响较小，但干眼症状重于行2.5mm同轴小切口白内障超声乳化术。术后晚期，两种切口对泪膜的长期影响无明显差异。

METHODS: Sixty-four patients(76 eyes)without dry eyes were selected and received phacoemulsification. The patients were divided into two groups randomly. Group A 30 patients(38 eyes)was performed with a 2.5mm mini-incision coaxial phacoemulsification and group B 34 patients(38 eyes)was performed with a sub 1.8mm micro-incision cataract surgery(MICS). Schirmer I test(SⅠt), tear break-up time(BUT), corneal fluorescein staining(CFS)and tear osmolarity were observed at 3d preoperatively and 1wk, 1, 3, 6mo and 1a postoperatively. The results were analyzed using a chi-square test and t-test with SPSS 19.0.

RESULTS:(1)Schirmer Ⅰ test(SⅠt): there was a significant increase in SIt at 1wk postoperatively. The difference between group A and group B was significant(P<0.01)at 1wk postoperatively, but it was insignificant at other postoperative time points(P>0.05).(2)Tear break-up time(BUT): there was a large reduction in BUT at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(3)CFS score: there was a large increase in CFS at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(4)Tear osmolarity: there was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The difference between group A and group B was significant(P<0.01). However, there were no significant differences between the two groups at other times(P>0.05).

CONCLUSION: The stability of tear film in patients underwent sub 1.8mm micro-incision cataract surgery(MICS)is much better than in patients received 2.5mm mini-incision coaxial phacoemulsification, but symptomys of dry eye in patients operated with MICS are much more serious during the early postoperative period. There is no significant difference in the long-term effects on tear film between the two types of incision.