目的：探讨维生素A棕榈酸酯眼用凝胶联合羧甲基纤维素钠对白内障超声乳化联合人工晶状体植入术后干眼的预防效果。

方法：选取2016-03/2017-08在我院行白内障超声乳化联合人工晶状体植入手术的年龄相关性白内障患者90例90眼，随机分为三组：对照组予以妥布霉素地塞米松滴眼液15d； 治疗Ⅰ组，在对照组治疗基础上予以羧甲基纤维素钠滴眼液30d； 治疗Ⅱ组，在治疗Ⅰ组基础上予以维生素A棕榈酸酯眼用凝胶30d。分别于术前1d和术后15、30d进行干眼主观症状评分、泪膜破裂时间(BUT)检查、角膜荧光素染色(FL)和泪液分泌试验(SⅠt)。

结果：术前1d，三组患者干眼主观症状评分、BUT值、FL评分和SⅠt值差异均无统计学意义(P>0.05)。干预后，各组患者干眼主观症状评分、FL评分和SⅠt值随时间延长均呈先升高后降低趋势，BUT值呈先降低后升高趋势。术后15、30d，治疗Ⅰ组和治疗Ⅱ组患者干眼主观症状评分、FL评分和SⅠt值均显著低于对照组，BUT值均明显高于对照组，且治疗Ⅱ组干眼主观症状评分和SⅠt值均明显低于治疗Ⅰ组，BUT值明显高于治疗Ⅰ组，差异均具有统计学意义(P<0.05)。

结论：白内障超声乳化联合人工晶状体植入术后初期存在一定程度眼表组织损伤，局部应用维生素A棕榈酸酯眼用凝胶联合羧甲基纤维素钠滴眼液可有效改善患者眼表情况及干眼临床症状。

METHODS: Ninety patients(ninety eyes)with age-related cataract enrolled in our hospital from March 2016 to August 2017 were performed phacoemulsification with intraocular lens implantation. They were randomly divided into three groups as control group(n=30), treated group Ⅰ(n=30)and treated group Ⅱ(n=30). The control group was administered with tobramycin and dexamethasone eye drops for 15d as the basis therapy. In treated group Ⅰ, patients were administered with carboxymethylcellulose sodium eye drops for 30d based on the treatment of the control group. The treated groupⅡ was administered with vitamin A palmitate eye gel for 30d on the basis of the treated group Ⅰ. The dry eye symptom score, corneal fluorescence(FL)staining scores, breakup time of tear film(BUT)and Schirmer Ⅰ test(SⅠt)without topical anesthesia were examined in 1d before operation and 15d and 30d after operation.

RESULTS: There were no statistically significant differences in subjective symptom scores of dry eye, BUT values, FL scores, and SⅠt values among the three groups before treatment(P>0.05). After treatment, dry eye symptom scores, FL scores, and SⅠt values increased at first and then decreased with time. BUT values decreased at first and then increased. Fifteen and thirty days after surgery, dry eye symptom scores, FL scores, and SⅠt values were significantly lower in the treated group Ⅰ and the treated group Ⅱ than in the control group. While BUT values were significantly higher than that in the control group. The dry eye symptom scores and SⅠt value of treated group Ⅱ were significantly lower than the treated group Ⅰ, and the BUT value was significantly higher than that of the treated group Ⅰ(P<0.05).

CONCLUSION: Phacoemulsification combined with intraocular lens implantation has a certain damage of ocular surface tissue on the initial stage. The application of vitamin A palmitate eye gel combined carboxymethylcellulose sodium eye drops can improve the dry eye symptoms.