CHEN Ding,HUANG Fang,ZHU Qiujian, et al. Effect of corneal incision size on tear function after phacoemulsification[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2014, 44(5): 342-.
Abstract：Objective: To explore the effect of different clear corneal incision size on change in tear function after phacoemulsification cataract surgery. Methods: Sixty patients (60 eyes) recruited for cataract surgery at the Eye Hospital of Wenzhou Medical University from November 2012 to May 2013 were randomly divided into two groups, A group (30 eyes) underwent regular 3.0 mm clear corneal incision phacoemulsification, group B (30 eyes) underwent 1.8 mm clear corneal micro-incision phacoemulsification. Before the surgery and 1 day, 1 week, 1 month, and 3 months after surgery, all subjects underwent measurements, including dry eye symptom score (DES), lower tear meniscus area (LTMA) and total tear meniscus area (TTMA) by optical coherence tomography (OCT), tear film break-up time (tBUT) and Schirmer test (ST-II). Statistic analysis used repeated measurement data analysis of variance, t-test and Pearson’s correlation. Results: In general, comparing to group A, the postoperative DES in group B was significantly lower (F=26.96, P=0.001), LTMA and TTMA in group B were significantly higher （F=56.21, 39.36, respectively, both P<0.001), tBUT in group B was significantly higher (F=28.39, P=0.001), and ST-II in group B was significantly higher (F=17.44, P=0.01). On 1 day and 1 week after surgery, DES in group B was significantly lower than that in group A （t=1.89, 1.55, respectively, both P<0.05). On 1 week after surgery, LTMA, TTMA and ST-II in group B were significantly higher than that in group A (t=1.38, 1.49, 1.82, respectively, all P<0.05). On 1 week, 1 month and 3 months after surgery, tBUT in group B was significantly higher than that in group A (t=2.32, 2.09, 1.58, respectively, all P<0.05). No significant difference was found at the other time points between the two groups. Comparing to the preoperative levels, DES in both groups increased on 1 day and 1 week after surgery (both P<0.05). Only in group A, the objective tear functional parameters changed significantly, such as LTMA (on 1 day and 1 week after surgery, both P<0.01), TTMA (on 1 day, 1 week and 1 month after surgery, Post Hoc, all P<0.05), tBUT (on 1 week after surgery, P<0.05), ST-II on 1 week and 1month after surgery, (both P<0.05), while no significant change was found in group B (all P>0.05). Conclusion: 1.8 mm clear corneal micro-incision phacoemulsification surgery has significantly less effect on change in tear function in the early postoperative period comparing to the 3.0 mm incision control, which has advantages in improving postoperative tear function and comfort.
