Objective:To investigate the changes on ocular surface after phacoemulsification in cataract patients suffering from diabetes,and to reveal the effects of preop-erative intervention.Methods:Sixty cataract patients from 50 to 75 years old with dry eye and diabetes were selected and randomly arranged into two groups:the preoperative intervention group was identified as Group A and the control group without preoperative intervention was named as Group B.For the two groups,tobramycin dexamethasone and sodium hyaluronate eye drops were al used after phacoemulsification.In addition,the clinical detection for both groups was processed 2 days before,1 week,1 month and 3 months after phacoemulsification including:dry eye questionnaire (DEQ),breakup time (BUT),Schirmer I test (SIt),fluorescein staining (FL),tear ferning test (TFT) and impression cytology of conjuesnctiva (IC).Results:1)According to the results of questionnaire,one week after phacoemulsification,there was no significant difference between the two groups (P >0.05).However,after one month,the main symptoms of subjects in Group A was described as photophobia and discomfort,while dryness,dis-comfort and photophobia in Group A (P <0.05).2)One week,one month and three months after surgery ,the BUT of group A was longer than that of group B (P <0.05). In addition,one week after the phacoemulsification,the SIt of the two groups were al increased,but after one month to three months,the SIt of the two groups were al re-duced;and then SIt in group A went backed to preoperative natural levels,while SIt in group B revealed significantly decreased level (P <0.05).Furthermore,after phacoe-mulsification in the two groups,conjunctival goblet cel s were al decreased,corneal fluorescein staining scores were increased at the same time,and crystal tears sheep were dentate downgraded,but in group A better recoveries were detected in al the three examinations (al P<0.05).Conclusion:After phacoemulsification for cataract patients suffering from diabetes,the symptoms of dry should be significantly increased.However,after reasonable treatment,ocular surface state could be recovered back to preopera-tive natural levels.For these patients,in order to improve the quality of visual and the quality of life,we should focus on the ocular surface state and intervention before the operation.%目的：：研究白内障合并有糖尿病的干眼患者,行白内障超声乳化吸除联合人工晶体植入术,观察术前后眼表状态的变化,术前积极干预后对患者术后眼表状况恢复的影响.方法：选取白内障合并糖尿病的干眼患者60例,共60眼,年龄在50－75岁之间,均需要行白内障超声乳化吸除联合人工晶体植入术,随机分为 A、B 组两组. A组30眼,为术前干预组,在术前使用玻璃酸钠滴眼液和维生素 A棕榈酸酯眼用凝胶进行治疗,直至眼表状态恢复正常；B组30眼,为对照组,术前未进行治疗；两组在术后均使用妥布霉素地塞米松滴眼液、玻璃酸钠滴眼液,在术前2天,术后1周、1月及3月分别进行眼表检查,内容包括：干眼症状调查、角膜荧光素染色(FL ,fluorescein stain test)、基础泪液分泌试验(SIt ,Schirmer I test)、泪膜破裂时间(BUT ,break up time)、泪液羊齿状结晶、结膜印迹细胞学检查.结果：1)问卷调查提示白内障术后1周A．、B两组干眼症状调查结果相似,差异无统计学意义(P ＞0．05)；术后1月 A组患者以畏光和眼部不适为主,B 组患者以干涩、眼部不适、畏光等症状为主,差异有统计学意义(P ＜0．05).2)两组患者术后1周、1月及3月,A组较 B组泪膜破裂时间延长,恢复速度快,差异有统计学意义(P＜0．05)；两组术后1周均有基础泪液分泌量增加的过程,术后1月至3月又逐渐减少,A组能恢复至术前正常水平,B组仍明显偏少,差异有统计学意义(P＜0．05)；两组术后都出现结膜杯状细胞均减少,角膜荧光素染色评分增加,泪液羊齿状结晶评级下降,但 A组较 B组术后这三项检查均恢复更好,差异有统计学意义(P＜0．05).结论：白内障合并糖尿病的干眼患者手术后干眼症状会明显加重,通过合理治疗可以逐渐缓解至术前水平；对于合并有糖尿病的白内障患者,手术前要关注其眼表状态,提前予以干预,待眼表状态恢复正常后再行手术治疗,可以更好的提高患者术后视觉质量和生存质量.
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