The early changes of tear film after phacoemulsification in diabetics

Objective To study the changes of tear film after phacoemulsification in diabetics. Methods 42 cases(60 eyes,test group) with diabetic cataract and 30 cases(42 eyes,control group)with age-related cataract who underwent phacoemulsification were chose and analysed the subjective complains of dry eye,tear break-up time,corneal fluorescein staining,tear film pattern by DR-1 tear interfermetry and Schirmer I test(SIt) value preoperatively and 1 day,1 week,1 month and 3 months postoperatively. Results Compared with the two groups preoperatively,the test group′s mean tear break-up time was less and the corneal fluorescein staining scores was more than that of control group( P 0.05).There was no significantly difference between the two groups′ subjective complains of dry eye,mean SIt value,grades of tear film pattern( P 0.05).Compared with the preoperation′s,the test group′s subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day,1 week and 1 month postoperatively( P 0.05).They all recovered their preoperative values at 3 months postoperatively( P 0.05).The control group′s subjective complains of dry eye increased and the mean tear break-up time reduced greatly at 1 day,1 week postoperatively( P 0.05).They all recovered their preoperative values at 1 month and 3 months postoperatively( P 0.05).The two groups′ corneal fluorescein staining scores and grades of tear film pattern increased significantly at 1 day and 1 week postoperatively( P 0.05).They all returned to their preoperative values at 1 month and 3 months postoperatively( P 0.05).The two groups′ mean SIt value increased significantly at 1 day postoperatively( P 0.05).It returned to its preoperative values at 1 week,1 month and 3 months postoperatively( P 0.05).At 1 month postoperatively,the longer the diabetes suffered,the higher the incidence of the corneal fluorescein staining 2 scores and BUT 5 seconds happened ( P 0.05).Among the diabetic history ≥10 years,the female′ incidence of BUT 5 seconds was higher than that of male ( P 0.05).BUT had negative correlation with the age (r=-0.41, P 0.05). Conclusions Non-insulin dependent diabetics are correlatrd with tear film dysfunction and are susceptible persons of the dry eye.The tear film stability of diabetic cataract reduced in early stage after phacoemulsification and recovered more slowly than that of age-related cataract.Especially involved the aged,female and longer history diabetics.