To Analysis The Influence On Ocular Surface After 2.2mm And 3.2mm Clear Corneal Incision For Ultrasonic Phacoemulsification Of Cataract

Objective: To observe the changes of ocular surface after 2.2mm and 3.2mm clear corneal incisions for ultrasonic.phacoemulsification of cataract by ocular Keratograph 5M.Methods:The patient who conform to the requirements,according to the order of coming to the hospital,from April 2018 till February 2019 at the Hunan Provincial People’s Hospital,who would undergo phacoemulsification combined with intraocular lens implantation,44 patients(47eyes)who age-related cataract were selected from our eye center.and they were randomly divided into 2 groups:group A has 22 patients(24 eyes),group B has 22 patients(23 eyes).Patients in group A were treated with 2.2mm clear corneal incision at 11 o’clock for ultrasonic phacoemulsification of cataract.and patients in group B were treated with 3.2mm clear corneal incision at 11 o’clock for ultrasonic phacoemulsification of cataract.All patients underwent routine ophthalmologic examination,and the meniscus height(TMH),non-invasive break up time(NIBUTf and NIBUTav),lipid layer and deficiency of meibomian gland grade,bulbar redness and limbus redness by ocular Keratograph 5M were measured preoperatively and 1 day,1 week,1 month,3 months postoperatively.Statistical analysis was used to compare the ocular surface function of the 2 groups.Results:(1)Non-invasive break up time(NIBUTf and NIBUTav): Non-invasive break up time(NIBUTf and NIBUTav)in patients of groups A in 1 day,1 week after the operation were significantly reduced than those before treatment(P < 0.05),Non-invasive break up time first(NIBUTf)in patients of groups B in 1 week after the operation were significantly reduced than those before treatment(P < 0.05),Non-invasive break up time average(NIBUTav)in patients of groups B in 1 day、1week、1month after the operation were significantly reduced than those before treatment(P<0.05),while levels of non-invasive break up time average(NIBUTav)in patients of group B were recovered in 3 month after the operation.(2)The meniscus height(TMH): The difference in preoperative THM between patients of these two groups was not significant(P>0.05).THM in patients of these 2 groups in 1 week after the operation were significantly decreased than those before treatment(P<0.05),THM in patients of two groups in 1 day,1 month、3months after the operation were significantly decreased than those before treatment(P<0.05).(3)Lipid layer thickness grading and Degree of meibomian gland loss: There were obvious changes in Lipid layer thickness grading and Degree of meibomian gland loss in both of the two groups compared with preoperative values,without statistically significant difference(P>0.05).(4)The conjunctival congestion score: The difference in preoperative The conjunctival congestion score between patients of these two groups was not significant(P>0.05).The level of bulbar conjunctival congestion in the two groups one day after surgery was higher than that before surgery(P<0.05),and the difference was statistically significant(P<0.05).There were significant differences between the temporal limbus and the preoperative one day,one week and one month after surgery(P<0.05).1 month after surgery,there was A statistically significant difference in nasal corneal congestion between group A and group B(P<0.05).Conclusion: 1.The effect of cataract phacoemulsification with a 2.2mm clear corneal incision on the tear film rupture time of the patients was no different than that of cataract phacoemulsification with a 3.2mm clear corneal incision.2.In comparison with the 3.2mm clear corneal incision,2.2mm clear corneal incision for ultrasonic phacoemulsification of cataract has less impairment in ocular surface of patients,2.2mm clear corneal incision more beneficial to the recovery of ocular surface.