目的：比较白内障超声乳化摘除术中分别行巩膜隧道切口与透明角膜隧道切口对泪膜的影响。 方法：将2012-02/2015-06在我院进行白内障手术的患者94例126眼纳入本研究。随机均衡分为研究组和对照组,研究组( A组)46例63眼,行巩膜隧道切口；对照组( B组)48例63眼,行透明角膜隧道切口。参考白内障LOCSⅡ核硬度分级标准细分为：AⅡ组、BⅡ组；AⅢ组、BⅢ组；AⅣ组、BⅣ组。患者在术前1 d和术后1、7、30、90 d进行主观干眼症状问卷评分( subjective sylptols of dry eye questionnaire scores,SDES),同时测定患者泪膜破裂时间(break-up tile,BUT)、角膜荧光素钠染色评分(staining scores of sodiul fluorescein, SCSF )、泪液分泌试验(Schirler l test,Slt),对比不同手术切口对患者泪膜影响。 结果：研究组和对照组患者术前泪膜功能指标进行比较,无统计学差异(P>0.05)；术后第1、7d,研究组和对照组患者泪膜功能指标与术前1d比较,差异均有统计学意义(P0. 05);there were statistically significant differences on tear film function of the two groups on preoperatively 1d with postoperatively 1 and 7d (P<0. 05). On postoperatively 30d, only the tear film function of BⅣ group had significant difference with that on preoperatively 1d(P<0. 05). SDES, SCSF and Slt of AⅢgroup on postoperatively 1d were significantly lower than those of BⅢ group (P<0. 05). SDES and SCSF of AⅣgroup on postoperatively 1 and 7d were lower than those of BⅣ group (P<0. 05). CONCLUSlON:ln the phacoemulsification, cataract withⅢ and Ⅳ nuclear through clear corneal tunnel incision, can sharpen tear film function damage, surgery effect was worse than through sclera tunnel incision, especially inⅣlevel nuclear. Therefore, scleral tunnel incision can be selected in grade Ⅳ nuclear cataract in phacoemulsification.
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