糖尿病患者白内障术后佩戴角膜绷带镜对干眼防治的临床疗效

Clinical Efficacy of Wearing Corneal Bandage Lens after Cataract Surgery for Prevention and Treatment of Dry Eye in Diabetic Patients

摘要: 目的：评价角膜绷带镜防治糖尿病患者白内障超声乳化术后干眼的安全性及有效性。方法：将2023-08月至2024-02月在济南普瑞眼科医院行PHACO + IOL植入术的40例(40眼)白内障合并2型糖尿病的患者，分为实验(佩戴绷带镜)组和对照组，平均每组20眼，将眼前节结构及炎症表现、最佳矫正视力(BCVA)、干眼症状评估量表值(SPEED)、眼表疾病指数值(OSDI)及非侵入性首次泪膜破裂时间(NIFBUT)作为2组术后评价指标。结果：术后2组患者均未眼前节炎症反应及眼前节结构改变等并发症。2组术后BCVA总体比较及不同时间点BCVA总体比较差异均具有统计学(F_组别 = 0.635, P = 0.430, F_时间 = 35.231, P < 0.001)。2组术后SPEED总体比较差异及不同时间点SPEED总体比较差异均有统计学意义(F_组别 = 42.615, P < 0.001, F_时间 = 41.453, P < 0.001)。2组术后OSDI总体比较差异及不同时间点OSDI总体比较差异均有统计学意义(F_组别 = 42.615, P < 0.001, F_时间 = 41.453, P < 0.001)。NIFBUT总体比较，对照组与实验(BCL)组差异均具有统计学意义(F_组别 = 2.241, P = 0.035)，NIFBUT在不同时间点间总体比较，对照组与实验(BCL)组差异无统计学意义(F_时间 = 1.462, P < 0.235)。结论：糖尿病患者白内障术后佩戴角膜绷带镜是安全、可靠的，并可大大提高泪膜稳定性，缓解干眼症状，降低白内障术后产生的不适症状。

Abstract: Objective: To evaluate the safety and effectiveness of wearing corneal banding lenses in preventing dry eye after phacoemulsification surgery for patients with diabetes mellitus and cataracts. Methods: A total of 40 cases (40 eyes) of patients with cataracts and type 2 diabetes mellitus who underwent PHACO + IOL implantation surgery at Jinan Puri Eye Hospital from August 2023 to February 2024 were divided into an experimental group (wearing banding lenses) and a control group, with an average of 20 eyes per group. The evaluation indicators for the two groups at postoperative time were anterior segment structure and inflammatory manifestations, best corrected visual acuity (BCVA), dry eye symptom assessment scale (SPEED) values, ocular surface disease index (OSDI) values, and non-invasive first tear film rupture time (NIFBUT). Results: After surgery, there were no complications such as anterior segment inflammatory response and anterior segment structural changes in both groups of patients. Postoperative BCVA values and differences at different time points in both groups showed statistically significant differences (F_group = 0.635, P = 0.430, F_time = 35.231, P < 0.001). Postoperative SPEED values and differences at different time points in both groups showed statistically significant differences (F_group = 42.615, P < 0.001, F_time = 41.453, P < 0.001). Postoperative OSDI values and differences at different time points in both groups showed statistically significant differences (F_group = 42.615, P < 0.001, F_time = 41.453, P < 0.001). NIFBUT values showed statistically significant differences between the control group and the experimental (BCL) group (F_group = 2.241, P = 0.035), but no statistically significant differences between the control group and the experimental (BCL) group at different time points (F_time = 1.462, P < 0.235). Conclusion: Wearing corneal banding lenses after cataract surgery in patients with diabetes mellitus is safe and reliable, significantly improving tear film stability, alleviating dry eye symptoms, and reducing postoperative discomfort.