羧甲基纤维素钠眼液治疗糖尿病合并白内障术后干眼的疗效分析

Efficacy of carboxymethylcellulose sodium eye drops in the management of dry eyes after phacoemulsification for diabetic cataract patients

摘要:

目的：分析糖尿病白内障超声乳化摘除术后羧甲基纤维素钠眼液治疗干眼症的临床效果。方法：选取2015年6月至2016年6月于我院行白内障超声乳化摘除术的糖尿病合并白内障患者117例（151眼），随机分为对照组（61例，84眼）和治疗组（56例，67眼），对照组予以常规白内障术后用药，治疗组在对照组基础上加用羧甲基纤维素钠眼液。对患者分别行术前及术后1 d、1周、1个月、2个月泪膜破裂时间（tear breakup time，BUT）、角膜荧光染色（cornea fluorescein staining，FL）、基础泪液分泌试验（ Schimer I test，SⅠt）检查和自觉症状评分。结果：所有糖尿病合并白内障术后患者干眼主观症状增加、BUT缩短、SⅠt延长、FL增多（P＜0.05）。至白内障术后2个月，对照组干眼主观症状仍较术前严重、BUT较术前缩短（P＜0.05）。治疗组术后1个月干眼主观症状、BUT和FL已接近术前水平（P＞0.05），且术后各时间点较对照组干眼主观症状更轻、BUT更长、FL更少（P＜0.05）。结论：糖尿病合并白内障超声乳化手术后使用羧甲基纤维素钠眼液可有效改善干眼症状、恢复泪膜稳定、缩短眼表功能修复时间。

Abstract:

Objective：To investigate the effect of carboxymethylcellulose sodium eye drops on the diabetic cataract patients with dry eye after phacoemulsification. Methods：A total of 117 patients underwent operation（151 eyes） with diabetic cataract referred to our hospital from June 2015 to June 2016 were enrolled in the study. Patients were randomly divided the control group（61 patients，84 eyes） and treatment group（56 patients，67 eyes）. The routine antibiotic and anti-inflammatory eye drops were used in control group，while treatment group was received carboxymethylcellulose sodium eye drops therapy except the routine treatment. Tear break-up time，Schimer I test，cornea fluorescein staining were measured，as well as subjective symptoms were graded before and on 1 day，at 1 week，1 month and 2 months after phacoemulsification and intraocular lens implantation. Results：All the subjective symptoms were worse，tear break-up time was shorter，S I t was prolonged and cornea fluorescein staining on epithelium was more commonly seen post-operation as compare to pre-operation（P<0.05）. The subjective symptoms grade and tear break-up time were still worse than the conditions that before operation in the control group 2 months post-operation（P<0.05）. However，the subjective symptoms grade，tear break-up time and cornea fluorescein staining on epithelium 1 month post-operation was similar to that pre-operation conditions（P>0.05），and all the post-opertation index were better in the treatment group than that in control group（P<0.05）. Conclusion：The carboxymethylcellulose sodium eye drops could efficiently relieve the symptoms of dry eye and maintain the tear film stable for the diabetic cataract patients underwent phacoemulsification.