实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (12): 1279-1283.doi: 10.3969/j.issn.1003-9198.2025.12.018

• 临床研究 • 上一篇    下一篇

20%自体血清联合人工泪液对老年白内障术后中度干眼症的临床疗效及安全性

刘海兰, 王赟   

  1. 810000 青海省西宁市,西宁市第一人民医院眼科
  • 收稿日期:2025-04-17 发布日期:2025-12-26

Clinical efficacy and safety of 20% autologous serum combined with artificial tears in the treatment of moderate dry eye disease following senile cataract surgery

LIU Hailan, WANG Yun   

  1. Department of Ophthalmology, Xining First People’s Hospital, Xining 810000, China
  • Received:2025-04-17 Published:2025-12-26

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摘要： 目的 探讨20%自体血清(autologous serum, AS)联合人工泪液(artificial tears, AT)治疗老年白内障术后中度干眼症(moderate dry eye disease, MDED)的临床疗效及安全性。 方法 回顾性分析2023—2024年西宁市第一人民医院收治的94例老年单眼白内障术后MDED病人,分为AS+AT组(47例)和AT组(47例)。2组均接受4周治疗。评价指标包括眼表疾病指数(ocular surface disease index, OSDI)评分、角膜荧光素染色(corneal fluorescein staining, CFS)、泪膜破裂时间(fluorescein breakup time,FBUT)、角膜感觉、泪液分泌试验(schirmer Ⅰ试验)及泪液炎症因子(TNF-α、IL-6、IL-1β)水平,并记录不良反应。 结果 AS+AT组总有效率显著高于AT组(78.7%比63.8%),治疗后2组角膜感觉正常率均显著提高,且AS+AT组改善更优(P<0.05)。AS+AT组FBUT和Schirmer I试验的改善程度显著优于AT组(均P<0.05),但2组间OSDI及CFS差异无统计学意义(P>0.05)。治疗后2组炎症因子水平均下降,且AS+AT组降幅更显著(均P<0.05)。2组不良反应总发生率差异无统计学意义(4.26%比2.13%,P>0.05)。 结论 AS+AT联合疗法可显著提升老年白内障术后MDED的临床疗效,改善角膜感觉与泪膜稳定性,并有效降低炎症因子水平,且安全性良好。

关键词: 自体血清, 人工泪液, 中度干眼症, 老年白内障

Abstract: Objective To assess the clinical efficacy and safety of 20% autologous serum (AS) combined with artificial tears (AT) in treating moderate dry eye disease (MDED) after senile cataract surgery. Methods A retrospective study was conducted on 94 elderly patients with unilateral MDED after cataract surgery from 2023-2024. The patients were divided into the AS+AT group (47 cases) and the AT group (47 cases) based on treatment regimens. Both groups underwent 4 weeks of treatment. The evaluation indicators included Ocular Surface Disease Index (OSDI), corneal fluorescein staining (CFS), tear film breakup time (FBUT), corneal sensitivity, Schirmer Ⅰ test and tear inflammatory factor levels such as tumor necrosis factor(TNF)-α, interleukin(IL)-6, IL-1β, and the adverse events were recorded. Results The total effective rate was significantly higher in the AS+AT group than that in the AT group (78.7% vs 63.8%). The normalization rate of corneal sensitivity after treatment was improved significantly in both groups, especially in the AS+AT group (P<0.05). FBUT and Schirmer Ⅰ test results showed significant differences between the AS+AT group and the AT group(P<0.05), while OSDI or CFS showed no significant differences (P>0.05). The levels of inflammatory factors (TNF-α, IL-6, IL-1β) decreased significantly in both groups after treatment, especially in the AS+AT group (P<0.05). No statistically significant difference was found in the total adverse event rate between the two groups (4.26% vs 2.13%). Conclusions AS combined with AT therapy significantly enhances the clinical efficacy in the elderly patients with unilateral MDED after cataract surgery with favorable safety, improves corneal sensitivity and tear film stability, and effectively reduces the levels of inflammatory factors.

Key words: autologous serum, artificial tears, moderate dry eye disease, senile cataract

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