Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India.
Indian J Ophthalmol. 2023 Apr;71(4):1517-1520. doi: 10.4103/IJO.IJO_2825_22.
A prospective cohort study was conducted in a tertiary eye care centre to study the incidence of tear film dysfunction and its recovery in diabetics and non-diabetics after clear corneal phacoemulsification.
A total of 50 diabetics and 50 non-diabetics underwent clear corneal phacoemuslfication. Schirmer's I test (SIT), tear film break-up time (TBUT), corneal staining, tear meniscus height (TMH), and ocular surface disease index (OSDI) assessment were done preoperatively, postoperatively at 7 days, 1 month, and 3 months in both groups to assess tear film function.
Both groups showed decreased SIT and TBUT values on postoperative Day 7, after which they gradually improved. SIT and TBUT values in diabetics were significantly lower than that in non-diabetics postoperatively (P < 0.001). SIT in non-diabetics reached baseline levels at postoperative 3 months. OSDI scores reached peak levels in both groups on postoperative Day 7, but were higher in diabetics than non-diabetics (P < 0.001). OSDI scores gradually improved over 3 months but remained over baseline levels in both groups. Corneal staining was positive in 22% diabetics and 8% non-diabetics at postoperative Day 7. However, none of the patients had corneal staining at 3 months. Tear meniscus height (TMH) did not reveal any significant difference between the two groups at any time interval.
We concluded that tear film dysfunction after clear corneal incision occurs in both groups, but is more severe and recovers more slowly in diabetics than non-diabetics.
在一家三级眼科中心进行了一项前瞻性队列研究,以研究在接受透明角膜超声乳化术后糖尿病患者和非糖尿病患者的泪膜功能障碍及其恢复情况。
共有 50 名糖尿病患者和 50 名非糖尿病患者接受了透明角膜超声乳化术。术前、术后 7 天、1 个月和 3 个月分别对两组患者进行 Schirmer Ⅰ试验(SIT)、泪膜破裂时间(TBUT)、角膜染色、泪膜高度(TMH)和眼表疾病指数(OSDI)评估,以评估泪膜功能。
两组患者术后第 7 天 SIT 和 TBUT 值均降低,此后逐渐改善。术后糖尿病患者的 SIT 和 TBUT 值明显低于非糖尿病患者(P <0.001)。非糖尿病患者的 SIT 在术后 3 个月恢复到基线水平。两组患者的 OSDI 评分均在术后第 7 天达到峰值,但糖尿病患者的评分高于非糖尿病患者(P <0.001)。OSDI 评分在 3 个月内逐渐改善,但两组均高于基线水平。术后第 7 天,22%的糖尿病患者和 8%的非糖尿病患者出现角膜染色,但 3 个月后所有患者均无角膜染色。在任何时间间隔,两组的 TMH 均无明显差异。
我们得出结论,透明角膜切口后两组患者均出现泪膜功能障碍,但糖尿病患者比非糖尿病患者更严重,恢复更慢。