摘要
目的:探究复方密蒙花蒸汽眼贴治疗白内障术后干眼的临床疗效。方法:前瞻性队列研究。连续性纳入2022年3—9月于郑州市眼科医院行超声乳化联合人工晶状体(IOL)植入术,且术后4周有干眼的白内障患者120例(120眼)。采用随机数字表法分为治疗组和对照组各60例(60眼),其中治疗组采用复方密蒙花蒸汽眼贴治疗,对照组采用模拟剂眼贴治疗,治疗周期为4周。所有患者均已在术前行干眼检查,分别于术后4、6、8周观察并记录干眼症状评分、泪膜破裂时间(BUT)、角膜荧光素钠染色评分(CFS)及基础泪液分泌试验(SⅠt)。2组患者手术前的性别、既往史比较采用卡方检验,年龄采用独立样本t检验,2组手术前后不同时间的干眼症状评分、BUT、CFS和SⅠt比较采用双因素重复测量方差分析。结果:2组患者的年龄、性别、既往史等人口基线特征差异均无统计学意义(均P>0.05)。在组间,术前和术后4周时,2组干眼症状评分、BUT、CFS、SⅠt差异均无统计学意义(均P>0.05);术后6、8周时,治疗组干眼症状评分均低于对照组(t=11.33,P=0.001;t=36.63,P<0.001);术后8周时,治疗组BUT、SⅠt均高于对照组(t=7.67,P=0.007;t=4.73,P=0.032)。在组内,治疗组干眼症状评分、CFS均在术后4周较术前升高,术后6、8周较术后4周逐渐降低,总体差异有统计学意义(F=54.10,P<0.001;F=8.26,P<0.001),BUT、SⅠt均在术后4周较术前降低,术后6、8周较术后4周逐渐升高,总体差异有统计学意义(F=38.05,P<0.001;F=24.59,P<0.001);对照组干眼症状评分、CFS均在术后4周较术前升高,术后6、8周较术后4周逐渐降低,总体差异有统计学意义(F=40.87,P<0.001;F=14.67,P<0.001),BUT、SⅠt均在术后4周较术前降低,术后6、8周较术后4周逐渐升高,总体差异有统计学意义(F=17.64,P<0.001;F=17.81,P<0.001)。结论:复方密蒙花蒸汽眼贴可以改善白内障术后干眼患者的干眼症状,提高泪膜的稳定性,增加泪液的分泌量,对白内障术后干眼有积极作用。
Objective:To investigate the clinical efficacy of compound Flos Buddlejae wet-hot compress eye patch on dry eye after cataract surgery.Methods:A prospective cohort study.One hundred and twenty cataract patients(120 eyes)who underwent phacoemulsification combined with intraocular lens(IOL)implantation in Zhengzhou Eye Hospital from March to September 2022 and had dry eye 4 weeks after surgery were enrolled consecutively.They were randomly divided into treatment group and control group,with 60 cases(60 eyes)in each group using a random number table method.The treatment group received compound Flos Buddlejae wet-hot compress eye patch treatment,while the control group received simulated agent eye patch treatment,with a treatment period of 4 weeks.All patients underwent preoperative dry eye examination,and dry eye symptom scores,tear film break-up time(BUT),corneal fluorescein staining(CFS),and SchirmerⅠtest(SⅠt)were observed and recorded at 4,6 and 8 weeks postoperatively.The preoperative count data of two groups of patients were analyzed using Chi square test,while the measurement data of two groups at different times before and after surgery were analyzed using two way repeated measures analysis of variance.Results:There was no statistically significant difference in demographic baseline characteristics such as age,gender,and past history between the two groups of patients(all P>0.05).There was no statistically significant difference in dry eye symptom scores,BUT,CFS,and SⅠt between the two groups before and 4 weeks after surgery(all P>0.05).At 6 and 8 weeks after surgery,the dry eye symptom scores in the treatment group were lower than those in the control group(t=11.33,P=0.001;t=36.63,P<0.001).At 8 weeks,BUT and SⅠt in the treatment group were higher than those in the control group(t=7.67,P=0.007;t=4.73,P=0.032).Within the group,dry eye symptom score and CFS in the treatment group increased at 4 weeks after surgery compared to preoperative score,and gradually decreased at 6 and 8 weeks after surgery compared to 4 weeks after surgery,with statistically significant overall difference(F=54.10,P<0.001;F=8.26,P<0.001).BUT and SⅠt both decreased at 4 weeks after surgery compared to preoperative score,and gradually increased at 6 and 8 weeks after surgery compared to 4 weeks after surgery,with statistically significant overall difference(F=38.05,P<0.001;F=24.59,P<0.001).Dry eye symptom score and CFS in the control group increased at 4 weeks postoperatively compared to preoperative score,and gradually decreased at 6 and 8 weeks postoperatively compared to 4 weeks postoperatively,with statistically significant overall difference(F=40.87,P<0.001;F=14.67,P<0.001).BUT and SⅠt both decreased at 4 weeks postoperatively compared to preoperative score,and gradually increased at 6 and 8 weeks postoperatively compared to 4 weeks postoperatively,with statistically significant overall difference(F=17.64,P<0.001;F=17.81,P<0.001).Conclusion:Compound Flos Buddlejae wet-hot compress eye patch can improve the dry eye symptom of patients with dry eye after cataract surgery,enhance the stability of tear film,increase the secretion of tears,and have a positive effect on dry eye after cataract surgery.
作者
杨宋阳
王骞
黄侠
朱俊英
利娇
陈鹏
Songyang Yang;Qian Wang;Xia Huang;Junying Zhu;Jiao Li;Peng Chen(Zhengzhou Second Hospital,Zhengzhou Eye Institute,Zhengzhou Eye Hospital,Zhengzhou 450006,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
北大核心
2024年第4期284-290,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
河南省医学科技攻关计划联合共建项目(LHGJ20230728)
关键词
白内障
手术相关性干眼
密蒙花
眼贴
cataract
dry eye related to eye surgery
Flos Buddlejae
eye patch
作者简介
通信作者:陈鹏,(ORCID:0009-0007-2891-2836),Email:13838181123@139.com
