ABSTRACT
Objective To analyze the dynamic relation between preoperative and postoperative subjective symptoms with the ocular surface and objective detection indexes of tear film structure and function in the patients with diabetic cataract phacoemulsification.Methods Thirty cases (30 eyes) with diabetic cataract were selected as the group A.Thirty cases (30 eyes) of age-related cataract were selected as group B.The two groups conducted the questionnaire survey of ocular surface disease index(OSDI) on preoperative 1 d,postoperative 1 week,i,3 months.The Keratograph 5M ocular surface analyzer was used to detect the tear river height,average tear film breakup time(TBUT),nasal conjunctival congestion score and nasal ciliary congestion score.The tear insulin and MUC5AC levels were detected by ELISA.Results The OSDI score at various time periods in the group A was higher than that in the group B (P＜0.05);The scores at postoperative 1 week in the two groups was increased compared with before operation(P＜0.05);the central lacrimal river height at postoperative 1 week in the two groups was decreased compared with before operation(P＜0.05).Average TBUT at postoperative 3 months in the group A approached the level before surgery,while which at postoperative 1 month in the group B closed to that before operation.The nasal conjunctival and ciliary congestion scores in the group A were higher than those in the group B(P＜0.05).The tear insulin and MUCSAC levels in the group A were lower than those in the group B,the differences were statistically significant (P＜0.05).The tear insulin level at postoperative 3 months gradually closed to the preoperative level,while the tear MUCSAC level still had obvious difference compared with preoperative level.Conclusion The changes of subjective symptoms and objective indexes of ocular surface and tear film after phacoemulsification in diabetic cataract patients are more obvious and the recovery time is more longer;the Keratograph 5M ocular surface comprehensive analyzer can serve as the routine method for observing the ocular surface and tear film function before and after cataract surgery in the patients with diabetes.