药物对Epi-LASIK术后上皮瓣活性影响的临床研究  

The clinical research of medicamentous effect on epithelial flap cell viability after epipolis laser in-situ keratomileusis

作　　者：杜之渝[1] 陈颖[1] 刘维锋[1] 黄正[1] 赵武校[1] 

机构地区：[1]重庆医科大学附属二院眼科中心,重庆400010

出　　处：《中国实用眼科杂志》2007年第9期953-957,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨如何使用药物来保持、提高角膜微型刀上皮下准分子激光角膜磨镶术（Epi-LASIK）术后早期上皮瓣活性。方法 2006年4月至9月在我院行Epi-LASIK手术矫正近视患者55例100眼分为四组。Ⅰ组用0.1%艾氟龙眼液4次/d;Ⅱ组双氯芬酸钠眼液4次/d;Ⅲ组术后0.5h内3次0.1%艾氟龙眼液,术后第一天滴0.1%艾氟龙眼液2次,贝复舒眼液4次,术后第二天开始仅用贝复舒眼液4次/d;Ⅳ组术后使用典必殊眼液4次/d;所有药物均在上皮瓣完全修复后即停用。通过随诊术后刺激症状、角膜上皮瓣水肿情况、角膜上皮修复时间、视力四个项目来讨论各组用药效果。结果 激素减轻术后的刺激症状的作用强于非甾体类;使用贝复舒眼液组比使用双氯芬酸钠眼液组上皮水肿消退快,且使用双氯芬酸钠眼液组又比一直使用激素组上皮水肿消退快;一直使用激素的患者上皮瓣修复需要更长的时间;各组视力均经历一个波谷后回升过程,使用贝复舒眼液组有效视力回升较快。结论 早期使用激素眼液（术后即刻至术后第一天）并结合贝复舒眼液有助于减轻Epi-LASIK术后的刺激症状、缩短上皮瓣的修复时间、加快有效视力的恢复。Objective To study how to use medication to maintain and elevate the early epithelial flap cell viability after Epi-LASIK（ epipolis laser in-situ keratomileusis ）.Methods Fifty-five patients （100 eyes） treated with Epi-LASIK between April and September 2006 were analyzed, and were randomly allocated four groups.Patients in group Ⅰ used 0.1% Fluorometholone （FML） eye drops q.i.d; Patients in group Ⅱ used Diclofenac Sodium eye drops q.i.d;Patients in group Ⅲ used three times drops 0.1% Fluorometholone （FML） in the first 30 minutes of postopration and two times drops in the first day of postopration, and started using Recombinant Bovine Basic Fibroblast Growth Factor （rb-bFGF） eye drops q.i.d after the flrst postoperative day ;Patients in group Ⅳ used Tobradex （Tobramyc in＋Dexamethasone） eye drops q.i.d.All medication were stopped after epithelial recovery.To compare the effects of four groups by evaluating irritation symptom . area of epithelial edema, the mean time of epithelial recovery, visual acuity（VA）.Results Patients used corticosteroids eye drops had less discomfort than patients used NSAID eye drops;Area of epithelial flap edema reduced more quickly in Patients used rb-bFGF eye drops than used Diclofenac Sodium eye drops, and the recovery of Patients used corficosteroids eye drops was most slowly; All patients recovered vision has a avalley, then to rise gradually; Patient＇s vision used rb-bFGF eye drops recovered more quickly.Conclusions Corticosteroids eye drops were used in the early stage （the first 30 minutes and the first day of postopration）and rb-bFGF eye drops were used （after the first postoperative day） are beneficial for alleviating discormfort, shorting the mean time of epithelial recovery and accelerating vision recovered.

关 键 词：EPI-LASIK 药物 临床研究 

分 类 号：R779.6[医药卫生—眼科]