方法：选取2014-06/2016-01我院接受超声乳化术的白内障患者86例106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53眼。A组采用2.2mm同轴超声乳化白内障术(44例53眼)，B组采用2.8mm同轴超声乳化白内障术(42例53眼)。观察两组患者的主观干燥异物感(dry eye symptom，DES)评分、泪膜破裂时间(break-up time，BUT)、泪液分泌试验(Schirmer's Ⅰ test，SⅠt)和眼睑刷上皮病变(lid-wiper epitheliopathy，LWE)，比较各项结果对患者影响程度的差异。

结果：两组患者术后1wk，1、3mo时的BUT与术前相比，均低于术前，其差异具有统计学意义(t= 3.098、4.512、4.329，均P<0.05)，且A组高于B组； 两组患者术后1wk和1、3mo时的DES评分与术前相比，均高于术前，其差异具有统计学意义(t=-9.449、-10.029、-7.141，均P<0.05)，且A组低于B组； 两组患者术后1wk和1、3mo时的 SⅠt与术前相比均高于术前，其差异具有统计学意义(t=-6.293、-4.009、 -3.283，均P<0.05)，且A组低于B组； 两组患者术后1wk和1、3mo时的LWE与术前相比，均高于术前，其差异均具有统计学意义(t=-6.542、-5.125、 -3.632，均P<0.05)，且A组低于B组。术后6mo时，A组患者的BUT、DES评分、SⅠt 和LWE与术前比较，差异无统计学意义(t=0.659、1.276、0.548、0.169，均P>0.05)； B组患者的BUT、DES评分、SⅠt 和LWE与术前比较，差异具有统计学意义(t=-4.063、7.306、3.621、4.208，均P<0.05)。

结论：白内障超声乳化手术切口大小对术后眼表和泪膜的变化具有一定的影响，手术切口的减小不仅可以降低对眼表组织的损伤，而且可以降低对术后泪膜及眼表的影响。

METHODS:Eighty-six patients(One hundred and six eyes)from 2014/06 to 2016/01 in our hospital were enrolled. The patients were randomly divided into two groups. Forty-four patients(Fifty-three eyes)in group A: coaxial 2.2mm micro-incision phacoemulsification cataract extraction and intraocular lens(IOL)implantation; Forty-two patients(Fifty-three eyes)in group B: the conventional coaxial 2.8mm small incision phacoemulsification cataract extraction and IOL implantation. The break up time(BUT), dry eye symptom(DES)score, Schirmer's I test(SⅠt)and lid-wiper epitheliopathy(LWE)score were assessed preoperatively and postoperatively.

RESULTS: At 1wk, 1 and 2mo postoperatively, 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=3.098, 4.512, 4.329; all P<0.05). 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=-9.449, -10.029, -7.141; 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=-6.293, -4.009, -3.283; all P<0.05). The LWE score in two groups increased after operations, the LWE score of group B was significantly higher than those of group A and the differences were statistically significant(t=-6.542, -5.125, -3.632; all P<0.05). At 6mo postoperatively, compared with the preoperative data, the BUT, DES score, SⅠt and LWE score in group A showed no statistically significant differences(t=0.659, 1.276, 0.548, 0.169; P>0.05). The BUT, DES score, SⅠt and LWE score in group B showed statistically significant differences(t=-4.063, 7.306, 3.621, 4.208; all P<0.05).

CONCLUSION: Ocular surface has less damage and tear film has little influence at early stage after the coaxial 2.2mm microincision phacoemulsification, compared with the conventional coaxial 2.8mm incision phacoemulsification surgery.