Influence Of Ocular Surface In 23G Vitrectomy Combined With Phacoemulsification

Object: To study the influence of ocular surface in patients who undergo 23 G vitrectomy combined with phacoemulsification.Methods: Continuous 102 cases(102 eyes) with vitreoretinal diseases and undergoing vitrectomy were included in this study. The cases with lens nuclear over grade III were in vitrectomy combined with phacoemulsification grouo(combination group,50 cases, 50 eyes) and the cases with lens nuclear less than grade III were in vitrectomy group(non combination group, 52 cases, 52 eyes). The ocular surface status were evaluated in pre-operation, and 7th, 30 th and 90 th day in post-operation.Results: Compared with the vitrectomy group, the corneal endothelial cells were significantly decreased in the combined group(P < 0.001). Compared with the preoperative IOP in both groups, the IOP values in 7th day post-operation were significantly increased(P < 0.001). However, no significant differences were detected in 30 th days and 90 th days of post-operative IOP in either group(P > 0.05). Ocular discomfort existed in both pre-operative and post-operative status. The postoperative discomfort symptoms contained foreign body sensation and jealous mainly. The discomfort symptoms were the same as pre-operative status in 90 days after surgery. Increased tear secretion, shorter tear break-up time and increased corneal fluorescein staining scores were detected in 7th day in post-operation, while there value returned to pre-operative in 90 th days post-operativly. Compared with the vitrectomy group, increased tear secretion, shorter tear break-up time and increased corneal fluorescein staining scores were detected in the combined group in 7th day in post-operation(P < 0.05). However, no differences of those values between vitrectomy and combined groups in 90 th days in post-operation(P > 0.05).Conclusion: The stability of tear film was decreased in early postoperative situation of 23 G vitrectomy. While the ocular discomfort symptoms and tear film stability parameters returned to the preoperative level 90 th days in post-operation. Vitrectomy combined with phacoemulsification deomonstrated server tear film influence compared the vitrectomy..