AIM:To study the influence on tear film by scleral tunnel incision and clear corneal tunnel incision in phacoemulsification.

METHODS:Ninety-four patients(126 eyes)who underwent cataract surgery from February 2012 to June 2015 in our hospital were selected in this study. They were divided into research group(group A)with 46 cases(63 eyes)underwent surgery though scleral tunnel incision, and the control group(group B)with 48 cases(63 eyes)through clear corneal tunnel incision. According to referencing cataract LOCS Ⅱ nuclear hardness classification standard, patients in the two groups were subdivided into AⅡgroup, BⅡ group, A Ⅲ group, B Ⅲ group, A Ⅳ group and B Ⅳ group. On preoperatively 1d, postoperatively 1, 7, 30 and 90d, subjective symptoms of dry eye questionnaire scores(SDES), break-up time(BUT), staining scores of sodium fluorescein(SCSF), and Schirmer I test(SⅠt)were determinate to analyze the influence on tear film by different incisions.

RESULTS:There were no statistically significant differences on preoperative tear film function between the two groups(P>0.05); there were statistically significant differences on tear film function of the two groups on preoperatively 1d with postoperatively 1 and 7d(P<0.05). On postoperatively 30d, only the tear film function of BⅣ group had significant difference with that on preoperatively 1d(P<0.05). SDES, SCSF and SⅠt of AⅢ group on postoperatively 1d were significantly lower than those of BⅢ group(P<0.05). SDES and SCSF of AⅣ group on postoperatively 1 and 7d were lower than those of BⅣ group(P<0.05).

CONCLUSION:In the phacoemulsification, cataract with Ⅲ and Ⅳ nuclear through clear corneal tunnel incision, can sharpen tear film function damage, surgery effect was worse than through sclera tunnel incision, especially in Ⅳ level nuclear. Therefore, scleral tunnel incision can be selected in grade Ⅳ nuclear cataract in phacoemulsification.