构建白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤风险模型并验证

doi:10.3969/j.issn.1671-7171.2025.07.006

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摘要【目的】构建白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤风险模型并验证。【方法】选取2020年7月至2023年7月在本院接受手术治疗的112例白内障合并干眼症患者,根据80/20定律随机分为训练集(n=90)和验证集(n=22)。所有患者入组后均行人工晶状体植入术,根据患者术后4周是否发生与干眼症相关的角膜上皮损伤分为损伤组和非损伤组。筛查白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤的影响因素,构建并验证预测模型。【结果】90例白内障合并干眼症患者中发生与干眼症相关的角膜上皮损伤34例(37.78%)。损伤组合并糖尿病占比、角膜水肿占比、眼压升高占比、眼表疾病指数(OSDI)、角膜荧光染色评分均高于非损伤组(P<0.05)。合并糖尿病、角膜水肿、眼压升高、OSDI评分高、角膜荧光染色评分高是白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤的危险因素(P<0.05)。列线图模型预测与干眼症相关的角膜上皮损伤的灵敏度为0.801,特异度为0.739,曲线下面积为0.828。列线图模型验证白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤的灵敏度为0.799,特异度为0.698,曲线下面积为0.810。【结论】合并糖尿病、角膜水肿、眼压升高、OSDI评分高、角膜荧光染色评分高与白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤有关,构建风险模型有助于辅助预测白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤。

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	王中利
	吕小霞
	仝皓鑫

关键词 ：白内障, 干眼病, 白内障摘除术, 上皮, 角膜, 比例危险度模型

Abstract：【Objective】To construct and validate a risk model for corneal epithelial damage related to dry eye after cataract surgery in patients with cataract and dry eye. 【Methods】 A total of 112 patients with cataract and dry eye who underwent surgery in our hospital from July 2020 to July 2023 were randomly divided into a training set (n=90) and a validation set (n=22) according to the 80/20 rule. All patients underwent intraocular lens implantation after enrollment. They were divided into the damage group and the non-damage group based on whether corneal epithelial damage related to dry eye occurred 4 weeks after surgery. The influencing factors of corneal epithelial damage related to dry eye after cataract surgery in patients with cataract and dry eye were screened, and a predictive model was constructed and validated. 【Results】Among the 90 patients with cataract and dry eye, 34 (37.78%) developed corneal epithelial damage related to dry eye. The proportion of patients with diabetes, corneal edema, elevated intraocular pressure, Ocular Surface Disease Index (OSDI), and corneal fluorescein staining score in the damage group was higher than that in the non-damage group (P<0.05). Diabetes, corneal edema, elevated intraocular pressure, high OSDI, and high corneal fluorescein staining score were risk factors for corneal epithelial damage related to dry eye after cataract surgery in patients with cataract and dry eye (P<0.05). The sensitivity, specificity, and area under the curve of the nomogram model for predicting corneal epithelial damage related to dry eye were 0.801, 0.739, and 0.828, respectively. The sensitivity, specificity, and area under the curve of the nomogram model for validating corneal epithelial damage related to dry eye in patients with cataract and dry eye after surgery were 0.799, 0.698, and 0.810, respectively. 【Conclusion】Diabetes, corneal edema, elevated intraocular pressure, high OSDI, and high corneal fluorescein staining score are associated with corneal epithelial damage related to dry eye after cataract surgery in patients with cataract and dry eye. The construction of a risk model is helpful for predicting corneal epithelial damage caused by dry eye.

Key words： Cataract Xerophthalmia Cataract Extraction Epithelium, Corneal Proportional Hazards Models

收稿日期: 2024-05-09

中图分类号:

R776.1

引用本文:

王中利, 吕小霞, 仝皓鑫. 构建白内障合并干眼症患者术后发生与干眼症相关的角膜上皮损伤风险模型并验证[J]. 医学临床研究, 2025, 42(7): 1123-1126.
WANG Zhongli, LYU Xiaoxia, TONG Haoxin. To Construct and Validate a Risk Model for Corneal Epithelial Damage Related to Dry Eye after Cataract Surgery in Patients with Cataract and Dry Eye. JOURNAL OF CLINICAL RESEARCH, 2025, 42(7): 1123-1126.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.07.006 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I7/1123

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