方法：选取152例169眼的非干眼患者，随机分为两组：A组76例83眼，行3.2mm角巩膜缘切口白内障超声乳化术； B组76例86眼，行巩膜隧道切口白内障超声乳化术。分别于术前，术后1wk； 1，3，6mo对患者行泪膜破裂时间(BUT)、角膜荧光素染色(CFS)、睑缘平行的结膜皱褶(LIPCOF)和眼睑刷上皮病变(LWE)分级检查。采用SPSS 17.0统计软件，对数据进行χ²检验和配对t检验分析。

结果：(1)BUT：两组在术后1wk； 1mo时均明显缩短，组间差异具有统计学意义(P<0.05)，而3，6mo时则无统计学意义(P>0.05)；(2)CFS评分：两组在术后1wk； 1mo时明显增加，组间差异有统计学意义(P<0.05)，3，6mo时则无统计学意义(P>0.05)；(3)睑缘平行的结膜皱褶：两组在术后1wk； 1，3mo时明显增加，组间差异具有统计学意义(P<0.05)，而6mo时则无统计学意义(P>0.05)；(4)眼睑刷上皮病变：两组术后1wk； 1mo时明显增加，组间差异有统计学意义(P<0.05)，而在3，6mo则无统计学意义(P>0.05)。

结论：术后早期行巩膜隧道切口手术对泪膜稳定性的影响较小，术后晚期两种切口对泪膜的长期影响无明显差异。

METHODS: Tear film was monitored in 152 patients(169 eyes)after phacoemulsification. Patients were divided into two groups according to the type of incision: group A(76 patients, 83 eyes)with a 3.2mm corneoscleral limbus incision phacoemulsification and group B(76 patients, 86 eyes )with a sclemtic tunnel incision. Tear break-up time(BUT), cornea fluorescein staining(CFS), lid-parallel conjunctival folds(LIPCOF)and lid-wiper epitheliopathy(LWE )were observed at 3d preoperatively and 1wk, 1, 3 and 6mo postoperatively. The results were analyzed using a Chi-square test and t-test with SPSS 17.0.

RESULTS:BUT: The BUT of two groups was obviously shorter at 1wk, 1mo postoperatively, the differences were statistically significant(P<0.05), however, there were no statistically significant at 3, 6mo(P>0.05). CFS score: There was a large increase in CFS at 1wk, 1mo postoperatively, the differences were statistically significant between the two groups(P<0.05), however, there were no statistically significant at 3, 6mo(P>0.05). LIPCOF: There was a large increase in LIPCOF at 1wk, 1 and 3mo postoperatively, the differences were statistically significant between the two groups(P<0.05), however, there were no statistically significant at 6mo(P>0.05). LWE: There was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The differences were statistically significant between the two groups(P<0.05), however, there were no statistically significant differences between the two groups at 3, 6mo(P>0.05).

CONCLUSION: The stability of tear film in patients with scleral tunnel incision is much better than in patients with 3.2mm corneoscleral limbus incision phacoemulsification. There is no significant difference between the two groups during later postoperative periods.