目的：评估0.01%次氯酸作为白内障超声乳化术前结膜囊消毒剂的效果和对眼表的影响。

方法：随机对照临床试验。285例单眼拟行白内障超声乳化手术的患者随机分为次氯酸组和聚维酮碘组，在消毒前后取结膜囊拭子，使用血琼脂培养基和巧克力琼脂培养基分别进行细菌培养和菌落形成能力(CFUs)测试。所有患者在消毒后2 h，1 d和1 wk接受眼部症状评分、疼痛程度评分的评估，并行角膜荧光素染色、眼红指数、泪河高度和非接触式泪膜破裂时间(NIBUT)检查，记录术后眼内炎的发生率。

结果：使用0.01%次氯酸进行结膜囊消毒可显著降低细菌培养阳性率和CFUs，与消毒前相比有差异(均P<0.01)，次氯酸消毒能力与聚维酮碘相当(χ²=0.811，P=0.368)。次氯酸组患者眼部症状评分和疼痛程度评分显著低于聚维酮碘组(均P<0.01)。次氯酸组角膜荧光素染色评分、眼红指数均显著低于聚维酮碘组(均P<0.01)。两组患者均无眼内炎发生。

结论：0.01%次氯酸作为结膜囊消毒剂安全有效，且患者的不适和对眼表的损伤较小。

METHODS: Randomized controlled clinical trial. A total of 285 patients who were scheduled for cataract phacoemulsification surgery were randomly divided into the hypochlorous acid group and the povidone iodine group. Before and after disinfection, conjunctival sac swabs were taken, and bacterial culture and colony-forming units(CFUs)testing were performed using blood agar and chocolate agar media, respectively. All patients were evaluated for ocular symptom scores and pain severity scores 2 h, 1 d, and 1 wk after disinfection, and underwent corneal fluorescein staining, eye redness index, tear meniscus height, and noninvasive breakup time(NIBUT)examination. The incidence of endophthalmitis after surgery was recorded.

RESULTS: Conjunctival sac disinfection with 0.01% hypochlorous acid significantly reduced the rate of positive bacterial cultures and colony-forming ability of the conjunctival sac, with statistically significant differences compared with the pre-disinfection period(both P<0.01), and the disinfecting ability of hypochlorous acid was comparable to that of povidone-iodine(χ²=0.811, P=0.368). The scores of ocular symptoms and pain severity in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(both P<0.01). The corneal fluorescein staining and eye redness index in the hypochlorous acid group were significantly lower than those in the povidone-iodine group(all P<0.01). No endophthalmitis occurred in either group of patients.

CONCLUSION: As a conjunctival sac disinfectant, 0.01% hypochlorous acid is safe and effective, with minimal discomfort and damage to the ocular surface in patients.