目的： 探讨玻璃酸钠滴眼液对年龄相关性白内障超声乳化联合IOL植入术后眼部炎症反应和干眼症的影响。

方法：回顾性分析我院2016-06/2017-07择期行超声乳化联合IOL植入术治疗的年龄相关性白内障患者200例200眼的临床资料，根据术后应用滴眼液的不同分为观察组和对照组(各100例)。观察组给予玻璃酸钠滴眼液，对照组给予妥布霉素地塞米松滴眼液。比较两组患者术前和术后第1、7、14d时泪膜破裂时间(break-up time，BUT)、角膜荧光素染色(fluorescein staining，FL)评分、房水蛋白浓度检查结果及眼表疾病指数(ocular surface disease index，OSDI)评分，并分析术后1、14d时结膜充血和睫状充血发生率。

结果：术前和术后1d时两组患者组间OSDI评分比较，差异均无统计学意义(P>0.05)； 术后1、7、14d时两组患者OSDI评分均高于术前，差异均有统计学意义(P<0.05)； 且两组患者OSDI评分在术后1d达到最高后逐渐下降(P<0.05)； 观察组术后7、14d时OSDI评分均低于对照组，差异均有统计学意义(P<0.05)。术前、术后1d时两组患者组间BUT比较，差异均无统计学意义(P>0.05)； 术后1、7、14d时两组患者BUT均低于术前，差异均有统计学意义(P<0.05)； 且两组患者BUT在术后1d达到最低后逐渐升高(P<0.05)； 观察组术后7、14d时BUT均高于对照组，差异均有统计学意义(P<0.05)。术前、术后1d时两组患者组间FL比较，差异均无统计学意义(P>0.05)； 术后1、7、14d时两组患者FL与术前比较，差异均有统计学意义(P<0.05)； 且两组患者FL在术后1d达到最高后逐渐下降(P<0.05)； 观察组术后7、14d时FL均低于对照组，差异均有统计学意义(P<0.05)。两组患者术后1d结膜充血、睫状充血发生率比较，差异均无统计学意义(P>0.05)； 术后14d两组患者结膜充血、睫状充血发生率均低于术后1d，差异均有统计学意义(P<0.05)，但对照组术后14d结膜充血、睫状充血发生率低于观察组，差异有统计学意义(P<0.05)。术后1、7、14d两组患者房水蛋白浓度与术前比较，差异均有统计学意义(P<0.05)； 且两组患者房水蛋白浓度在术后1d达到最高后逐渐下降(P<0.05)，对照组术后7、14d房水蛋白浓度均低于观察组，差异均有统计学意义(P<0.05)。

结论：玻璃酸钠滴眼液改善年龄相关性白内障超声乳化联合IOL植入术后干眼症状作用较妥布霉素地塞米松滴眼液显著，但是对于眼部炎症作用没有妥布霉素地塞米松滴眼液强。综合考虑，对于炎症作用轻、创伤小的超声乳化联合IOL植入术后患者可选玻璃酸钠滴眼液。

METHODS: The clinical data of age-related cataract patients treated with phacoemulsification combined with IOL implantation in 200 cases(200 eyes)of our hospital from June 2016 to July 2017 were retrospectively analyzed. According to the different postoperative application of eye drops they were divided into observation group and control group(100 cases each). The observation group was given sodium hyaluronate eye drops and the control group was given tobramycin dexamethasone eye drops. The results of BUT, FL, proteins concentration in aqueous and ocular surface disease index(OSDI)score were compared before and at the first day, the seventh day and the fourteenth day after the operation. And the incidence of conjunctival hyperemia and ciliary hyperemia was compared between 1d after surgery and 14d after surgery.

RESULTS: There was no significant difference in OSDI scores between the two groups before and at 1d after surgery(P>0.05). The OSDI score of the two groups was higher than that before the operation on the first, the seventh and the fourteenth day after surgery(P<0.05). The OSDI score of the two groups decreased gradually after reaching the highest level on the first day after surgery(P<0.05). The OSDI scores of the observation group on the 7 and 14d after surgery were lower than those in the control group(P<0.05). There was no significant difference in the BUT between the two groups before and at 1d after surgery(P>0.05). The levels of BUT in the two groups were lower than those before operation on the first, the seventh and the fourteenth day after surgery(P<0.05). BUT levels in both groups increased gradually after reaching the lowest level on the first day(P<0.05), the levels of BUT in the observation group were higher than those in the control group on the 7 and 14d after operation(P<0.05). There was no significant difference in FL level between the two groups before and the first day after operation(P>0.05). The levels of FL in the two groups were different from those before operation(P<0.05)on the first, the seventh and the fourteenth day after operation(P<0.05). FL levels in the two groups decreased gradually after reaching the highest level on the first day after surgery(P<0.05), the levels of FL in the observation group on the 7th day and the 14th day after operation were lower than those in the control group(P<0.05). There was no significant difference in the incidence of conjunctival hyperemia and ciliary congestion between the two groups on the first day after operation(P>0.05); the incidence of conjunctival hyperemia and ciliary hyperemia in the two groups on the fourteenth day after surgery was lower than that on the first day after surgery(P<0.05). However, the incidence of conjunctival hyperemia and ciliary congestion on the fourteenth day after operation was significantly lower in the control group than in the observation group(P<0.05). Postoperatively 1, 7, 14d, aqueous humor protein concentration in the two groups of patients compared with preoperative had difference(P<0.05), and two groups of patients with aqueous humor at postoperatively 1d after reaching the highest protein concentration decreased(P<0.05), aqueous humor protein concentrations of the control group 7, 14d after operation were lower than the observation group(P<0.05).

CONCLUSION: The effect of sodium hyaluronate eye drops on improving dry eye after age-related cataract phacoemulsification combined with IOL implantation is greater than that of tobramycin dexamethasone eye drops, but it is less effective for eye inflammation than tobramycin dexamethasone eye drops. After comprehensive consideration, for the patients with light inflammation, small incision phacoemulsification combined with IOL implant, sodium hyaluronate eye drops is a good selection.