白内障合并糖尿病患者术前干眼综合治疗的疗效观察OA

·AIM:To observe the preoperative and postoperative clinical efficacy of comprehensive dry eye treatment in cataract patients complicated with diabetes mellitus,with a focus on comparing the differences between the two groups in terms of postoperative dry eye symptoms,tear film function,visual recovery,and complication rates,aiming to provide an effective protocol for the perioperative management and long-term prognosis improvement in this patient population. ·METHODS:Patients diagnosed with both cataract and diabetes mellitus and presenting with varying degrees of dry eye symptoms,scheduled for cataract surgery at the hospital from May 2023 to December 2024,were enrolled as study subjects.They were divided into two groups using a random number method:the control group received sodium hyaluronate eye drops alone,and the experimental group underwent comprehensive preoperative dry eye treatment(sodium hyaluronate eye drops+warm compress+meibomian gland cleaning and massage+Chinese herbal fumigation+health guidance).Tear film breakup time(BUT),corneal fluorescein staining(FL),Ocular Surface Disease Index(OSDI)score,tear meniscus height(TMH),and non-invasive first tear film breakup time(NIBUT)were compared between the two groups before and after 4 wk of treatment.Meibomian gland loss,tear film lipid layer thickness,and basic ocular symptoms were also assessed. ·RESULTS:This study included 60 eyes of 60 patients,with a control group of 30 eyes of 30 patients(aged 56.24±10.24 y,13 males and 17 females)and an experimental group of 30 eyes of 30 patients(aged 58.01±9.79 y,15 males and 15 females).After 4 wk of preoperative treatment,the BUT in the experimental group increased from 4.09±1.13 s to 10.35±1.46 s,and from 4.15±1.05 s to 8.26±1.36 s in the control group,showing a significant intergroup difference(t=5.737,P<0.001).The FL score in the experimental group decreased from 6.83±0.46 points to 2.86±0.38 points,whereas in the control group it decreased from 6.79±0.39 points to 5.32±0.43 points(t=23.480,P<0.001).After 4 wk of treatment,the NIBUT in the experimental group increased from 5.19±1.12 s to 9.36±1.47 s,compared to an increase from 5.21±1.04 s to 7.18±1.25 s in the control group(t=6.188,P<0.001).The proportion of patients with a thin tear film lipid layer was significantly higher in the experimental group than in the control group(all P<0.01).Ocular clinical symptoms decreased after treatment in both groups,with the experimental group showing lower scores than the control group(all P<0.001). ·CONCLUSION:Preoperative comprehensive dry eye treatment can multi-dimensionally improve dry eye symptoms and tear film stability in cataract patients with diabetes mellitus,providing an effective strategy for the perioperative management of cataract patients.