老年前期白内障和年龄相关性白内障围手术期干眼症的差异特征、机制和临床策略
Differential Characteristics, Mechanisms, and Clinical Strategies for Perioperative Dry Eye in Presenile Cataract and Age-Related Cataract.
摘要(中文译文)
随着白内障发病年龄呈现双峰分布，早老性白内障（40-55岁）与年龄相关性白内障（≥70岁）在围手术期干眼表现上存在显著差异。本综述旨在系统比较二者的差异特征、机制及管理策略。采用间接证据综合方法，纳入71项评估这两类患者群体围手术期干眼的临床与机制研究。早老性患者主要表现为继发于睑板腺功能障碍的蒸发过强型干眼（55-70%），术后持续3-6个月，尤其在合并代谢紊乱、女性、糖尿病合并玫瑰痤疮或术前焦虑的亚组中更为明显。相比之下，年龄相关性患者主要表现为混合型干眼，恢复期较短（1-3个月），以角膜神经脱髓鞘和睑板腺纤维化为特征。在机制方面，早老性组与腺体功能过载、急性炎症及外源性氧化应激相关，而年龄相关性组则表现为退行性萎缩、慢性低度炎症（衰老相关分泌表型，SASP）及神经再生受损。围手术期干眼在早老性与年龄相关性白内障患者之间存在固有差异，需要采用年龄分层和亚组靶向的管理策略以实现精准的眼表护理。然而，由于缺乏直接的头对头研究，这些发现源自间接证据，应被视为假设生成性结论。
Abstract
: With the biphasic of cataract onset age, presenile cataract (40-55 years) and age-related cataract (≥70 years) demonstrate notable differences in perioperative dry eye manifestations. This review aims to systematically compare their differential characteristics, mechanisms, and management strategies. : An indirect evidence synthesis was conducted, encompassing 71 clinical and mechanistic studies evaluating perioperative dry eye in these two patient populations. : Presenile patients predominantly present with evaporative dry eye secondary to meibomian gland dysfunction (55-70%), persisting for 3-6 months postoperatively, especially in subgroups with metabolic disorders, female sex, diabetes with rosacea, or preoperative anxiety. In contrast, age-related patients primarily exhibit mixed-type dry eye, with a shorter recovery period (1-3 months), characterized by corneal nerve demyelination and meibomian gland fibrosis. Mechanistically, the presenile group is associated with glandular functional overload, acute inflammation, and exogenous oxidative stress, while the age-related group shows degenerative degenerative atrophy, chronic low-grade inflammation (senescence-associated secretory phenotype, SASP), and impaired nerve regeneration. : Perioperative dry eye exhibits inherent differences between presenile and age-related cataract patients, requiring age-stratified and subgroup-targeted management strategies for precise ocular surface care. However, due to the absence of direct head-to-head studies, these findings are derived from indirect evidence and should be considered hypothesis-generating.
如何引用
AMA
Ruisi Huang, Yuanling Xia. Differential Characteristics, Mechanisms, and Clinical Strategies for Perioperative Dry Eye in Presenile Cataract and Age-Related Cataract.. Healthcare (Basel, Switzerland). 2026; doi:10.3390/healthcare14131960.
APA
Ruisi Huang, Yuanling Xia (2026). Differential Characteristics, Mechanisms, and Clinical Strategies for Perioperative Dry Eye in Presenile Cataract and Age-Related Cataract.. Healthcare (Basel, Switzerland). https://doi.org/10.3390/healthcare14131960
GB/T 7714
Ruisi Huang, Yuanling Xia. Differential Characteristics, Mechanisms, and Clinical Strategies for Perioperative Dry Eye in Presenile Cataract and Age-Related Cataract.[J]. Healthcare (Basel, Switzerland), 2026 doi:10.3390/healthcare14131960.
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