方法：选择2019-04/2021-04我院收治的合并2型糖尿病的白内障手术患者212例212眼作为研究对象，根据术后并发干眼情况将患者分为干眼组(43例43眼)和无干眼组(169例169眼)，比较两组患者的一般资料、术后1wk实验室检查指标、生活质量评分情况； 采用多因素Logistic回归分析影响术后并发干眼的危险因素； 构建列线图预测模型并评价其预测准确性。

结果：两组患者角结膜疾病史、翼状胬肉、睑板腺功能障碍、晶状体核硬度、疾病认知水平、术后焦虑、术后抑郁、手术切口、用药依从性、术后1wk血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、糖化血红蛋白(HbA1c)水平均有差异(P<0.05)； 多因素Logistic回归分析结果显示，术后焦虑、术后抑郁、手术切口为3.0mm、术后1wk IL-1β>31.26ng/mL、IL-6>29.42ng/mL、TNF-α>77.68ng/mL、HbA1c≥6.50%均是导致患者术后并发干眼的危险因素(P<0.05)； 列线图预测模型的校准曲线和标准曲线拟合度良好，预测概率大多分布在0和1附近，准确性较高； 干眼组患者的视功能评价、环境触发因素、眼部不适症状、眼表疾病指数(OSDI)总评分均明显高于无干眼组(P<0.05)。

结论：手术切口、术后焦虑、抑郁、用药依从性、血清炎症因子及HbA1c水平均与2型糖尿病患者白内障术后并发干眼有关，早期识别危险因素并及时进行干预，有利于降低术后干眼发生率，提高患者生活质量。

METHODS: A total of 212 patients(212 eyes)with type 2 diabetes who underwent cataract surgery in our hospital from April 2019 to April 2021 were selected. The patients were divided into dry eye group(43 cases, 43 eyes)and non-xerophthalmia eye(169 cases, 169 eyes). The general data, laboratory examination index and quality of life score of the two groups were compared; multivariate Logistic regression analysis was used to analyze the risk factors of postoperative xerophthalmia; constructed a line chart prediction model and evaluated its prediction accuracy.

RESULTS: There were significant differences in the history of keratoconjunctival disease, pterygium, meibomian gland dysfunction, lens nucleus hardness, disease cognition, postoperative anxiety, postoperative depression, surgical incision, medication compliance, and the levels of interleukin-1β(IL-1β), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)and HbA1c at 1wk after operation between the two groups(P<0.05). The results of multivariate Logistic regression analysis showed that postoperative anxiety, postoperative depression, 3.0mm of surgical incision, IL-1β>31.26ng/mL, IL-6>29.42ng/mL, TNF-α>77.68ng/mL and HbA1c≥6.50% were risk factors for postoperative xerophthalmia(P<0.05). The calibration curve and standard curve of the nomogram prediction model were fit well, and the prediction probabilities were mostly distributed around 0 and 1, with high accuracy.The visual function evaluation, environmental trigger factors, ocular discomfort symptoms and ocular surface disease index(OSDI)score in the dry eye group was significantly higher than those in the non-xerophthalmia group(P<0.05).

CONCLUSION: Surgical incision, postoperative anxiety, depression, medication compliance, serum inflammatory factors and HbA1c are all related to xerophthalmia after cataract surgery in patients with type 2 diabetes. Early identification of risk factors and timely intervention are helpful to reduce the incidence of postoperative xerophthalmia and improve the quality of life.