表皮生长因子减轻准分子激光上皮下角膜磨镶术后反应和促进上皮修复的临床研究  

Effects of epidermal growth factor (EGF) on postoperative inflammation and epithelial healing after LASEK

作　　者：于志强[1] 陈冲达[1] 李瑾[1] 周浩[1] 干德康[1] 周行涛[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《眼视光学杂志》2007年第1期24-26,共3页Chinese Journal of Optometry & Ophthalmology

摘　　要：目的准分子激光上皮下角膜磨镶术后早期使用重组人表皮生长因子衍生物,通过观察术后反应,评价外源性表皮生长因子促进角膜上皮修复的作用。方法采用随机、双盲、平行组对照试验,治疗组58例采用金因舒+0.1%氟美瞳+0.3%泰利必妥,对照组60例单用0.1%氟美瞳+0.3%泰利必妥,术后观察疼痛、畏光、流泪、异物感、混合性充血、角膜上皮混浊6项指标,按无、轻、中、重分别记为0、1、2、3分。术后第1、第2、第3、第5天观察术后反应并评分,术后第1、第2、第3周检查视力,术后第1、第2、第3个月观察角膜雾状混浊(Haze)发生情况。第5天开始根据指征尽早取镜。结果术后第1天和第2天治疗组术后反应评分为7.02±3.33和4.98±3.30,对照组为8.28±3.77和6.45±3.75,两组差异有显著性(P<0.05)。治疗组平均取镜时间为5.5d,对照组为6.2d,治疗组早于对照组。两组恢复最佳视力的时间差异没有显著性,术后Haze的发生治疗组和对照组分别为28眼和31眼,均不超过0.5级,两组差异没有显著性。结论重组人表皮生长因子衍生物能减轻LASEK术后早期反应,缩短术后绷带镜片的佩戴时间,安全、无毒副作用,有助于LASEK术后角膜上皮化学性和机械性损伤的修复。Objective To evaluate effects of ectogenous epidermal growth factor （EGF） on postoperative inflammation and epithelial healing after LASEK.Methods FLAy-eight myopia patients （including both eyes of each palieat） were topically treated with recombimmt human epidermal growth factar （thEGF） ＋ 0.1% fluorometholone ＋ 0.3 % of loxacin after treatment with LASEK. Sixty patients with the same surgery were treated as control where treatment of 0.1% fluommetholone ＋ 0.3 % of laxacin was topically used. Clinical observation on the eyes was followed at 1, 2, 3 and 5 days postoperatively. Visual acuity was measured at 1, 2 and 3 weeks postoperatively. Corneal haze was assessed at 1, 2 and 3 months past.operatively. A total score was used to record all adverse responses of each eye. Results The average scorn for the EGF group was 7.02± 3.33 at day 1 and4.98±3.30 at day 2.The average score for the control group was 8.28±3.77 at day 1 and 6.45 ± 3.75 at day 2. The overall average score in the EGF group was significently lower than in the control group （ P 〈 0. 05）. There was no dig ferenee in rapidity of achieving best uncorrected visual acuity between the two groups. The number of eyes with corneal haze were 28 eyes for the EGF group and 31 eyes for the control group. The severity of corneal haze was lower than 0.5 score for the two groups. Conclusion rhEGF may relieve early inflammation after LASEK and is safe and beneficial to the epithelial healing after the surgery.

关 键 词：表皮生长因子 角膜磨镶术 激光上皮下 角膜上皮 术后反应 

分 类 号：R779.63[医药卫生—眼科]