比较0.10%与0.04%聚维酮碘溶液对人眼表的影响  

Effect of povidone iodine solution on human ocular surface:a comparison between two different concentrations

作　　者：李冰[1] 盛敏杰[1] 林安娟[1] 汪维芳[1] 李艳红[1] 谢春蕾[1] 丁玲娣[1] 沈艳[1] 

机构地区：[1]同济大学附属第十人民医院眼科,上海200072

出　　处：《上海医学》2008年第9期625-627,共3页Shanghai Medical Journal

摘　　要：目的探讨0.10%与0.04%聚维酮碘溶液结膜囊滴用对人眼表的影响。方法按市售说明稀释成0.10%(A组)和0.04%(B组)聚维酮碘溶液行内眼术前结膜囊消毒,在裂隙灯显微镜下观察眼表损伤情况,并将结膜囊分泌物涂片行细胞学检查和免疫组织化学检测。结果术中,A组有28眼见结膜囊内有大量白色黏性分泌物,B组仅6眼有少量黏性分泌物。术后24 h,A组有25眼出现疼痛、畏光、流泪,裂隙灯显微镜下见结膜囊内较多量黏性分泌物,结膜充血,角膜上皮点状或片状剥脱,43眼出现1～3级程度不等的角膜水肿;B组有4眼存在轻微的疼痛、畏光、流泪等刺激症状,6眼出现1级角膜水肿;两组间眼表损伤情况及角膜水肿临床分级的差异均有统计学意义(P值均<0.05)。随访1个月,A组有3眼存在疼痛、畏光等刺激症状,2眼出现一系列干眼综合征的临床表现;B组未见明显的眼表损伤症状;两组术眼眼表损伤情况及角膜水肿临床分级的差异均无统计学意义(P值均>0.05)。结论0.10%聚维酮碘溶液对术眼眼表上皮具有损伤作用。在确保消毒效果的前提下,应尽量使用低质量分数的聚维酮碘溶液。Objective To observe the effects of two different concentrations of povidone iodine（PI） solutions （conjunctival sac drops） on human ocular surface. Methods The conjunctival sacs were disinfected by 0.10% （group A）PI and 0.04% （group B）PI before operation. The eyes were examined by slit lamp for ocular surface injury. The secretion of conjunctival sac was examined using cytologic and immunobistocbemical methods. Results During the surgery a large amount of white conjunctival sac secretion was found in 28 eyes in group A and only in 6 eyes in group B. Twenty-four hours after surgery,25 eyes in group A had pain, pbotophobia, tears, a great amount of conjunctival sac secretion, corneal epithelial point or flake stripping under slit lamp, and 43 eyes had level 1-3 corneal edema; while 4 eyes in group B had slight pain, photophobia, tears, etc. , and 6 eyes had level 1 corneal edema. The ocular surface injuries and clinical degrees of corneal edema were significantly different between group A and group B （all P〈0.05）. Three eyes in group A still had pain and pbotophobia one month later and 2 eyes had eye manifestations. No distinct ocular surface injury was observed in group B. There were no significantly differences in neither ocular surface injuries nor clinical degrees of corneal edema between group A and group B （all P〉0. 05）. Conclusion 0.1% PI can cause injury to the ocular surface. While ensuring the disinfecting efficacy, we should choose low concentrations of PI for disinfection.

关 键 词：聚维酮碘 眼表 角膜损伤 内眼手术 

分 类 号：R779.66[医药卫生—眼科] R779.1[医药卫生—临床医学]