[关键词]
[摘要]
目的：探讨Resight非接触式广角镜与传统角膜接触镜在增生性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)患者眼前后节联合手术后眼表的差异性比较。
方法：回顾性分析2014-01/12在新疆自治区中医院眼科住院收治的白内障合并增生性糖尿病视网膜病变的患者96例96眼，其中采用白内障超声乳化摘除+人工晶状体植入联合23G玻璃体切割术辅助Resight非接触式广角镜48例48眼设为试验组，对照组48例48眼为采用传统角膜接触镜，余均同对照组。两组患者性别及年龄、病程均匹配。观察术前、术后第1、7、30d的角膜厚度(corneal thickness，CT)、基础泪液分泌量(Schirmer's test，SⅠt)、泪膜破裂时间(breaking-up time， BUT)、角膜荧光染色(corneal fluorescein staining，CFS)。
结果：两组患者术前各项指标均无统计学差异，两个组手术前后各时间点的CT值总体比较差异有统计学意义(F时间=748.355，P=0.000； F组别=27.196，P=0.000)，其中对照组术后各时间点角膜厚度均明显增加，与术前相比，差异均有统计学意义(P<0.05)； 两个组手术前后不同时间点SⅠt值总体比较差异有统计学意义(F时间=571.094，P=0.000)，其中两组术后1、7d S I t值与术前相比差异均有统计学意义(P<0.05)，术后30d S I t值均逐渐恢复至术前水平； 两个组手术前后不同时间点的BUT值总体比较差异有统计学意义(F时间 =843.122，P=0.000； F组别=24.664，P=0.000)，其中对照组术后各时间点BUT值均缩短，与术前比较差异有统计学意义(P<0.05)，两个组术眼CFS值不同组间和不同时间点的变化差异均有统计学意义(F时间 =312.093，P=0.000； F组别=16.232，P=0.000)，其中，两个组患者术后各时间点的CFS值均高于术前，差异均有统计学意义(P<0.05)。
结论：Resight非接触式广角镜在PDR患者眼前后节联合手术后对眼表影响小，术后干眼症状较轻。
[Key word]
[Abstract]
AIM: To evaluate the difference of ocular surface between Resight non-contact wide-angle lens and conventional corneal contact lens in the patients with proliferative diabetic retinopathy(PDR)after phacoemulsification combined with intraocular lens(IOL)implantation and vitrectomy.
METHODS: A retrospective cases-controlled study was designed.Ninety-six patients(96 eyes)with PDR and cataract were included in this study from January 2014 to December 2014 in Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region.The 48 cases(48 eyes)in experiment group were treated with Resight non-contact wide-angle lens,the 48 cases(48 eyes)in control group with conventional corneal contact lens. Corneal thickness(CT), Schirmer's test(SⅠt),breaking-up time(BUT)and corneal fluorescein staining(CFS)were taken before operations and at 1d,1wk and 1mo after operations.
RESULTS: All indicators of the two groups had no significant differences preoperatively. Significant differences were found on CT value between the experiment group and control group as well as among 4 time points(Ftime=748.355,P=0.000; Fgroup=27.196,P=0.000). The CT value of the control group increased obviously after surgeries, the differences were significant compared with preoperative(P<0.05). The SⅠt of the two groups among the 4 points were significantly different(Ftime =571.094,P=0.000). The SⅠt of the two groups at 1d and 1wk were significantly different compared with those preoperative(P<0.05). The SⅠt of the two groups at 1mo postoperatively recovered to the same level as before surgeries. The BUT value between the two groups as well as among 4 time points were significantly different(Ftime=843.122,P=0.000; Fgroup=24.664,P=0.000). The BUT decreased after surgeries and the differences were significant, compared with those before surgeries(P<0.05). The CFS value between the two groups as well as among 4 time points were significantly different(Ftime =312.093,P=0.000; Fgroup=16.232,P=0.000). The CFS value after surgeries was higher than those before surgeries and the differences were significant(P<0.05).
CONCLUSION: Resight non-contact wide-angle lens has little influence on the ocular surface in the patients with PDR after phacoemulsification combined with IOL implantation and vitrectomy.
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