| Objective Objective to analyze the ocular surface after 23G vitrectomy to guide the postoperative treatment.Methods Totally 216 patients?48 with type 2 diabetes,group A,and 40 with hypertension,group B,56 with type 2 diabetes and hypertension,group C,72 with type 2 diabetes and hypertension,group D?who underwent 23-gauge vitrectomy were entolled in this prospective case-controlled study.The fellow eyes were used as control group.The score of meibomian gland and lipid layer,red eyes symptoms,Tear meniscus height?TMH?,Break-up time?BUT?,Schirmer I test?SIT?,and corneal fluorescein staining?CFS?were recorded 1 day before and 3d,7d.,14d,and lmo,after surgery in all patients.Data from all ophthalmologic examinations were collected.Results1.Compared with 1 day before surgery,the meibomian gland loss was obvious after operation in e ach group?Z?A?=-4.633,Z?B?=-6.085,Z?C?=-7.613,Z?D?=-7.251,P<0.05?,the lipid 1 ayer color was single?Z?A?=-3.052,Z?B?=-4.989,Z?C?=-2.271,Z?D?=-5.882,P<0.05?,red eyes were obvious at 3 and 7 days after surgery?Z?A?=-8.110?-6.045,Z?B?=-8.048?-7.744,Z?C?=-9.386?-9.035,Z?D?=-10.485?-8.897,P<0.05?,adt 3 and 7 days after operatio n,the LTMH scores was higher,the BUT scores was shorter,and the SIT scores was higher?LT MH:Z?A?=-6.039?-5.858,Z?B?=-5.517?-5.525,Z?C?=-6.548?-6.527,Z?D?=-7.174?7.379,P<0.05;BUT:Z?A?=-5.724?-3.704,Z?B?=-5.521?-5.517,Z?C?=-6.516?-5.977,Z?D?=-3.952?-4.727,P<0.05:SIT:Z?A?=-6.051?-6.074,Z?B?=-5.541?-5.553,Z?C?=-6.541?-6.552,Z?D?=-7.399?-7.400,P<0.05?,the group D was restored to 14 days after sur gery,and the other groups were recovery after surgery 30 days;CFS scores higher?Z?A?=-6.100.-6.064?-4.157,Z?B?=-5.562?-5.541?-4.873,Z?C?=-6.541?-6.580?-5.186,Z?D?=-7.407?-7.200?-6.149,P<0.05?.,recovered after 1 month.2.Compared with the contralateral eye,the postoperative meibomian glandular gland loss was significant in each group?Z?A?=-5.048,Z?B?=-6.122,Z?C?=-7.540,Z?D?=-5.611,P<0.05?,the lipid layer has a single color?Z?A?=-2.853,Z?B?=-3.994,Z?C?=-2.271,Z?D?=-6.038,P<0.05?,red eyes were obvious 3 and 7 days after surgery?Z?A?=-8.409,-6.502,Z?B?=-7.961,-7.535,Z?C?=-9.282,-8.648,Z?D?=-10.376,-8.635,P<0.05?,LTMH scores was higher,BUT scores was shorter,and SIT value was higher at 3 and 7 days after operation?LTMH scores:Z?A?=-0.473,-4.930,Z?B?=-5.521,-5.537,Z?C?=-5.204,-5.26,Z?D?=-0.998,-6.262,P<0.05;SIT scores:Z?A?=-6.046,-6.046,Z?B?=-5.265,-5.55,Z?C?=-6.306,-6.074,Z?D?=-7.393,-7.421,P<0.05;BUT value:Z?A?=-5.806,-5.284,Z?B?=-5.521,-5.383,Z?C?=-6.515,-5.82,Z?D?=-3.952,-3.941,P<0.05?,the higher CFS scores at 3,7,and 14 days?Z?A?=-2.828,-6.06,-6.00,Z?B?=-5.533,-5.555,-4.873,Z?C?=-6.550,-6.334,-4.70 Z?D?=-7.406,-7.414,-6.190,P<0.05?.Compared with group D surgical eyes,group C glandular glandular abscess?Z=-2.980,P<0.05?,lipid layer single?Z=-2.049,P<0.05?,1 day before surgery,3 postoperatively LTMH scores were high at 7 and 30 days?Z=-3.275,-5.99,-6.931,-3.740,P<0.05?,and the SIT scores were lower at each time point?Z=-4.504,-9.362,-8.566,-2.533,-2.318,P<0.05?,BUT scores were shorert at each time point?Z=-5.191,-4.512,-3.114,-5.479,-4.993,P<0.05?,and CFS scores was higher at 30 days postoperatively?Z=-3.200,P<0.05?.3.Compared with group D surgical eyes,group C glandular gland abscess,single lipid layer,1 day before surgery,3,7 and 30 days after surgery,high LTMH values,low SIT values at various time points and BUT values The CFS scores were short and 30 days after surgery,and the differences were statistically significant?P<0.05?.Compared with group A,the glandular gland was absent in group C,the redness was obvious at 3,7,and 14 days after operation,the LTMH value was high at each time point,and the SIT value was small at 3,7,and 14 days after surgery.The 30-day BUT value was short,and the CFS scores were high at 3,14 and 30 days after operation,and the differences were statistically significant?P<0.05?.Compared with group B,group C had high LTMH values at 3,7 and 14 days after surgery,1 day before surgery,3 days and 30 days after surgery,and fewer SIT values,1 day before surgery,3,14 and 30 days after surgery.The CFS score was high,and the difference was statistically significant?P<0.05?.The difference was not statistically significant.Conclusion1.All groups of patients caused ocular surface changes after 23G vitrectomy.2.Patients with diabetes or hypertension have poor ocular surface and recovery is slower than those without hypertension or diabetes.3.The ocular surface changes in patients with hypertension and diabetes are more significant than those in the diabetic and hypertensive groups.Early use of artificial tears to protect the ocular surface and control blood pressure and blood glucose levels can help improve vision and quality of life. |
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