| The first part The effect of 5% povidone-iodine before cataract surgery on the changes of ocular surface and tearObjective: To observe the effects of 5% Povidone Iodine(PI)disinfection of the conjunctival sac before cataract surgery and normal people on the changes of ocular surface and tear fluid at different times.Materials and Methods:Sixty patients with 60 eyes who underwent Phaco+IOL surgery in Hainan Eye Hospital from June 2020 to December 2020 were selected.They were randomly divided into two groups;30s group,1min group,3min group,20 eyes in each group.All eyes should be disinfected with 5% PI conjunctival sac before operation,disinfection for 30 s,1min,and 3min respectively;First noninvasive keratograph tear breakup time(NIBUTf),Average noninvasive keratograph tear breakup time(NIBUTav),Tear Meniscus Height(TMH),jeal analysis score,meibomian gland morphology score,corneal apex epithelial The thickness and corneal fluorescein staining were checked;the Ocular surface disease index(OSDI)before and 1 week after the operation was observed.Result : NIBUTf,NIBUTav: There was no statistical significance among the three groups of 30 s,1min,3min and before and after the operation of each group(P>0.05);TMH: 1d after operation in 1min group was significantly higher than 30 s group and3 min group,which was statistically significant(P<0.05);there was no statistical significance in each group before and after operation(P>0.05);Jeal analysis score:30s,1min and 3min group 1d after operation was significantly higher than that before operation,30 s group and 1min group 1w after operation was significantly lower than1 d after operation,with statistical significance(P<0.05);30s,1min,3min three The comparison between the groups was not statistically significant(P>0.05);the meibomian gland morphology score: 30 s,1min,3min,and the comparison between the three groups before and after the operation,there was no statistical significance(P>0.05);Central corneal epithelial thickness: 1 min group and 3 min group after 1day are higher than preoperative and postoperative 1w,which is statistically significant(P<0.05);there is no statistical significance among the three groups of 30 s,1min,and 3min(P>0.05);Corneal fluorescence staining score: 1d after operation and1 w after operation in each group were significantly higher than before operation,and1 w after operation was significantly lower than 1d after operation,which was statistically significant(P<0.001);comparison between the three groups was not statistically significant Significance(P>0.05);OSDI score: There was no statistical significance between the three groups of 30 s,1min,and 3min and the comparison of each group before and 1w after operation(P>0.05).Conclusion The application of 5% PI to disinfect the conjunctival sac before cataract surgery has a short-term effect on the ocular surface,which basically returns to normal after a week.It has nothing to do with the length of 30 s,1min and 3min disinfection of the conjunctival sac.It is the result of the interaction of many factors.The second part The effect of 5% povidone-iodine on the changes of ocular surface and tear fluid in normal peopleObjective:Observe the effect of normal people using 5% povidone iodine(Povidone Iodine,PI)to disinfect the conjunctival sac at different times on the changes of ocular surface and tear fluid.Materials and Methods : Thirty volunteers were recruited from December 2020 to January 2021.One eye was enrolled in the group,and they were randomly and double-blindly divided into 30 s group,1min group,and 3min group,with 10 eyes in each group.All subjects used 5% PI to disinfect the conjunctival sac for 30 s,1min,and 3min;observe the NIBUTf,NIBUTav,TMH,jealous analysis scores,and tarsal plate before,10 min,1d,1w after 5% PI instillation Glandular morphology score,corneal apex epithelium thickness,corneal fluorescein staining score;observe Schirmre test II(ST II)and conjunctival imprinting cytology before instillation,1d and 1w after instillation.Result:NIBUTf,NIBUTav,TMH,Meibomian gland morphology scores: 30 s,1min,3min,and before and after instillation,there was no statistical significance(P>0.05);jealous analysis score: 10 min after instillation in each group Significantly higher than before instillation,1d after instillation,and 1w after flushing,with statistical significance(P<0.001);comparison between the three groups of 30 s,1min,and 3min,without statistical significance(P>0.05);corneal central epithelium Thickness: 10 min after instillation in the 1min and 3min groups was significantly higher than before and1 w after instillation,which was statistically significant(P<0.05);there was no statistical significance among the three groups of 30 s,1min,and 3min(P>0.05));Corneal fluorescence staining score: the scores of each group at 10 minutes after instillation were significantly higher than before,1 day after instillation and 1 week after instillation,which was statistically significant(P<0.001);among the three groups of 30 s,1min,and 3min Comparison,no statistical significance(P>0.05);ST II:1d after instillation in each group was significantly lower than before and 1w after instillation,statistically significant(P<0.05);30s,1min,3min three groups There was no statistical significance between the comparisons(P>0.05);there was no statistical significance between the three groups of 30 s,1min,3min and before and after instillation in each group(P>0.05).The results of conjunctival imprinting cytology:the baselines of the goblet cell density of the supratemporal bulbar conjunctiva before instillation in the 30 s,1min and 3min groups were 414.40±103.54,407.20±104.13,and 392.80±104.75;the baselines of the three groups were 1d after instillation,respectively 399.20±91.0,398.40±94.72,383.80±87.23;1w baseline after instillation in the three groups were 366.00±82.73,362.80±79.77,359.00±70.31;there was no statistical difference between the groups(P>0.05);the three groups of conjunctiva The density of goblet cells showed a downward trend before and after instillation,but the results showed no significant statistical difference(P>0.05).The degree of conjunctival cell squamous epithelial metaplasia: There was no statistical difference between the three groups and before and after the instillation of the three groups using the Nelson score results(P>0.05).Conclusion Normal people use 5% povidone-iodine to disinfect the conjunctival sac.After10 minutes,signs of conjunctival hyperemia,corneal epithelial edema,and punctate defects appear,and the observation almost returns to normal after 1 week.There was no significant difference between the 30 s group,the 1min group and the 3min group,but the 30 s group did not have obvious corneal epithelial edema 10 min after the instillation,and the corneal epithelial edema was observed 10 min after the 1min group and the 3min group. |
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