Effect Of Different Incisions On Dry Eye Symptoms After Cataract Surgery In Diabetic Patients

Purpose:To study and analyse the effect of different cataract surgical incisions on postoperative dry eye symptoms in type 2 diabetic patients.Methods:Thirty-six patients with type 2 diabetes who underwent cataract surgery in the Eye Center of Bethune Second Hospital of Jilin University from August 2021 to December 2022 were randomly divided into three groups,with 12 patients in each group,2.4mm clear corneal incision group,3.0mm clear corneal incision group and corneoscleral rim incision.The patients in different incision groups were examined by Ocular Surface Disease Index、Schirmer I test and OCULUS Keratograph 5M,compare the symptoms and signs of dry eye in patients in the different incision groups preoperatively,1 week postoperatively,1 month postoperatively and 3 months postoperatively.Results:(1)Intra-group comparison of different surgical incisions: The OSDI,TBUT,SIt and ciliary congestion of patients were significantly different from those before operation,and the difference was statistically significant(P < 0.05).On the 7th day after operation,conjunctival congestion changed significantly compared with that before operation,and the difference was statistically significant(P < 0.05).(2)Comparison between different surgical incision groups: 7 days and 1m after operation,OSDI,SIt,TBUT and ciliary congestion of corneoscleral rim incision group were better than those of clear corneal incision group.Only 7 days after operation,conjunctival congestion in corneoscleral rim incision group was worse than that in clear corneal incision group.(3)Comparison between clear corneal incision groups: 7 days after operation,all the indexes of 1m and 2.4mm clear corneal incision group were better than those of 3.0mm clear corneal incision group.(4)Before and at any time after cataract surgery,there was no significant difference in TMH,meibomian gland loss score and lipid layer grading between different incision groups(P > 0.05).(5)There was no significant difference in all indexes between groups and within groups in different incision groups before and 3 hours after operation(P >0.05).Conclusion:(1)Different surgical incisions of cataract have obvious effects on the postoperative dry eye of patients with type 2 diabetes,among which the corneoscleral rim incision group has the lightest postoperative dry eye symptoms,followed by the2.4mm clear corneal incision group,and the 3.0mm clear corneal incision group has the most serious postoperative dry eye symptoms.(2)For diabetic patients with poor glucose control,severe meibomian gland loss and severe dry eye before operation,it is necessary for clinicians to change the surgical method,and it may be more reasonable to choose corneoscleral rim incision.