目的：探讨糖尿病患者玻璃体切除术中使用不同角膜保护剂对眼表的影响。方法：将2019-01/2020-01本院拟行玻璃体切除术的糖尿病患者90例90眼随机分为HPMC组、SHSCS组和BSS组，各30例30眼，HPMC组和SHSCS组术中分别使用羟丙基甲基纤维素(HPMC)和透明质酸钠-硫酸软骨素钠(SHSCS)覆盖角膜表面避免角膜干燥，BSS组术中使用平衡盐溶液(BSS)不断滴眼保持角膜湿润。手术前后分别行泪液分泌试验(SⅠt)和泪膜破裂时间(BUT)检查，并测量角膜中央厚度，观察对比其变化情况。结果：术后1wk，1mo，BSS组相比HPMC组、SHSCS组，SⅠt明显增加，BUT明显缩短(均P<0.05)； 术后1wk，HPMC组相比SHSCS组BUT明显缩短(P<0.05)； 术后3mo，三组患者SⅠt、BUT较术前均无明显差异(P>0.05)。术后第1d，BSS组相比HPMC组、SHSCS组角膜中央厚度明显增加(均P<0.05)； 术后1wk，三组患者角膜中央厚度较术前均无明显差异(P>0.05)。结论：糖尿病患者行玻璃体切除术中使用HPMC、SHSCS均可以保护角膜，维持泪膜的稳定性，临床上可以根据实际情况选择不同的角膜保护剂。

AIM: To investigate effects of different corneal protective agents on ocular surface in vitrectomy in patients with diabetes.METHODS: Totally 90 patients(90 eyes)with diabetes who received vitrectomy were randomly divided into HPMC group(30 eyes), SHSCS group(30 eyes)and BSS group(30 eyes). Hydroxypropyl methyl cellulose(HPMC)and sodium hyaluronate sodium chondroitin sulfate(SHSCS)were used to cover the corneal surface to avoid the cornea drying in HPMC group and SHSCS group, respectively. Balanced salt solution(BSS)was continuously dripped on the cornea to keep the cornea moist in BSS group. Schirmer Ⅰ test(SⅠt), breaking up time(BUT)and central corneal thickness were performed before and after operation. Their changes were observed and compared.RESULTS: At 1wk and 1mo after operation, compared with HPMC group and SHSCS group, SⅠt was significantly increased and BUT was significantly shortened in BSS group(P<0.05). At 1wk after operation, BUT of HPMC group was significantly shortened compared with SHSCS group(P<0.05). At 3mo after operation: SⅠt and BUT of the three groups were no significant difference compared with before operation(P>0.05). At 1d after operation, the corneal thickness of BSS group was significantly increased compared with HPMC group and SHSCS group(P<0.05). At 1wk after operation, the corneal thickness of the three groups were no significant difference compared with before operation(P>0.05).CONCLUSION:The patients with diabetes use HPMC and SHSCS can protect the cornea and maintain the stability of tear film in vitrectomy. Different corneal protectors can be selected according to the clinical practice.