方法：选取2013-05/2014-05来我院接受超声乳化术的白内障患者90例90眼。采取随机分组的方式，将其分为两组，分别为A组和B组，每组各45例45眼。A组患者为微切口组，行2.2mm同轴超声乳化白内障吸除术，B组为小切口组，行常规3.0mm同轴超声乳化白内障吸除术。观察两组患者的DES(dry eye symptom)评分、BUT(break-up time)、SⅠt(Schirmer's Ⅰ test)和CFS(corneal fluorescein staining)评分，比较各项结果对患者影响程度的差异。

结果：术后10、20、30d，两组患者的DES评分均高于术前，且B组的DES评分明显高于A组，差异具有统计学意义(t=-9.501、-10.070、-7.961，均P<0.05)； 两组患者的BUT均低于术前，且B组的BUT明显低于A组，差异具有统计学意义(t=3.110、4.477、4.331，均P<0.05)； 两组患者的SⅠt均高于术前，且B组的SⅠt明显高于A组，差异具有统计学意义(t=-6.288、-4.012、-3.277，均P<0.05)； 两组患者的CFS评分均高于术前，且B组的CFS评分明显高于A组，差异具有统计学意义(t=-11.672、-5.851、-4.677，均P<0.05)。术后90d，A组患者的DES评分、BUT、SⅠt和CFS评分与术前相比差异不明显，无统计学意义(t=1.290、0.606、0.559、0.178，均P>0.05)； B组患者的DES评分、BUT、SⅠt和CFS评分与术前相比差异明显，具有统计学意义(t=7.321、4.071、3.620、4.214，均P<0.05)。

结论：白内障超声乳化术角膜切口大小对术后眼表和泪膜的变化具有一定的影响，切口小的能有效降低手术对患者眼表所造成的损伤，且术后早期对泪膜和眼表的影响比较小。

METHODS:Ninety patients(90 eyes)from May 2013 to May 2014 in our hospital were enrolled. The patients were randomly divided into two groups. Forty-five patients(45 eyes)in group A: coaxial 2.2mm micro-incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation; forty-five patients(45 eyes)in group B: the conventional coaxial 3.0mm small incision phacoemulsification cataract extraction and IOL implantation. The dry eye symptom(DES)score, break up time(BUT), Schirmer's Ⅰ test(SⅠt)and corneal fluorescein staining(CFS)score were assessed preoperatively and postoperatively.

RESULTS: At 10, 20 and 30d postoperatively, the DES score in two groups increased, the DES score of group B was significantly higher than those of group A and the differences were statistically significant(t=-9.501, -10.070,-7.961; all P<0.05). The BUT in two groups decreased after operations, and the BUT of group B was significantly lower than those of group A, the differences were statistically significant(t=3.110, 4.477, 4.331; all P<0.05). The SIt in two groups increased after operations, the SⅠt of group B was significantly higher than those of group A and the differences were statistically significant(t=-6.288, -4.012, -3.277; all P<0.05). The CFS score in two groups increased after operations, the CFS score of group B was significantly higher than those of group A and the differences were statistically significant(t=-11.672, -5.851, -4.677; all P<0.05). At 90d postoperatively, compared with the preoperative data, the DES score, BUT, SⅠt and CFS score in group A showed no statistically significant differences(t=1.290, 0.606, 0.559, 0.178; P>0.05). The DES score, BUT, SIt and CFS score in group B showed statistically significant differences(t=7.321, 4.071, 3.620, 4.214; all P<0.05).

CONCLUSION: Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.2mm micro incision phacoemulsmcation, compared with the conventional coaxial 3.0mm incision phacoemulsification surgery.