目的：观察1g/L玻璃酸钠滴眼液对行20G闭合式玻璃体切除手术(PPV)的增殖性糖尿病视网膜病变(proliferation diabetic retinopathy，PDR)患者眼表的保护作用。

方法：采用随机单盲病例对照研究。选取因PDR在西安市第四医院眼科住院并由同一术者行20G PPV手术的2型糖尿病患者，随机分为PDR对照组(A组)及玻璃酸钠治疗组(B组)，B组在手术后第1d即加用1g/L玻璃酸钠滴眼液持续滴术眼至术后2mo，比较两组在术前、术后1wk，1、3mo OSDI、SⅠt、BUT、角膜荧光素染色(fluorescein cornea staining，FL)及角膜共焦显微镜下泪膜、角膜上皮细胞层情况。

结果：共90例90眼参与研究，其中A组45眼，B组45眼。两组术前均有干眼表现，组间比较差异无统计学意义(P>0.05)。A组眼表损伤在术后进一步加重并且在观察期未能随时间延长恢复； B组术后不同观察时间部分指标较术前好转，术后A、B两组差异显著(P<0.05)。

结论：并发PDR的2型糖尿病患者接受20G PPV手术后联合使用1g/L玻璃酸钠滴眼液能够减轻患眼眼表不适症状，促进泪膜及角膜上皮层修复。

METHODS: Randomized single blind case control study was used. Patients with type 2 diabetes who were admitted to the department of ophthalmology, Xi'an No.4 Hospital for PDR and underwent 20G PPV surgery by the same surgeon were randomly divided into PDR control group(Group A)and sodium hyaluronate treatment group(Group B). Group B received continuous 1g/L sodium hyaluronate eye drops from 1d to 2mo after surgery. Before and 1wk, 1, 3mo after surgery, OSDI, SⅠt, BUT, fluorescein cornea staining(FL)and the tear film and corneal epithelial cell layer under corneal laser scanning confocal microscopy of the two groups were compared.

RESULTS:A total of 90 cases and 90 eyes were studied. In preoperative time, the two groups showed obvious dry eye syndrome, and compared with the control subjects, there were no significant difference existed between the two groups(P>0.05). In group A, ocular surface injury was further aggravated after surgery and failed to recover with time extension during the observation period.Some indexes of Group B improved at different observation time after surgery compared with those before surgery, and there were significant differences between group A and Group B after surgery(P<0.05).

CONCLUSION: Applying 1g/L sodium hyaluronate eye drops could relief the uncomfortable feeling of ocular surface in patients with PDR after 20G vitrectomy and accelerate the recovery of ocular surface disorders.