降眼压药物治疗LASIK术后屈光回退的效果评估和机制探讨  

Curative effect evaluation and mechanism discussion of IOP-lowering medication on regression after LASIK

作　　者：牟章兵 李旭松[2] 朱晋 向金梅 谢艾芮 

机构地区：[1]成都三六三医院眼视光部,中国四川省成都市610041 [2]昆明梯古眼科医院,中国云南省昆明市650034

出　　处：《国际眼科杂志》2008年第10期2074-2076,共3页International Eye Science

基　　金：中国四川省卫生厅科研课题(No.070190)~~

摘　　要：目的:评估降眼压药物—2.5g/L马来酸噻吗洛尔眼液治疗LASIK术后屈光回退的疗效,并初步探讨其作用机制。方法:选取使用2.5g/L马来酸噻吗洛尔眼液治疗的LASIK术后屈光回退患者25例(46眼),收集治疗前和治疗1mo后的UCVA、BSCVA、屈光度、角膜前表面曲率、眼压、屈光度与角膜前表面曲率的变化值,进行配对t检验。结果:治疗1mo后的UCVA由治疗前的0.63±0.27上升为0.95±0.33(t=9.07,P<0.01),其中提高1行的14眼(30%),提高2行以上的27眼(59%),不变的5眼(11%),有效率达89%;BSCVA治疗前为1.19±0.27,治疗1mo后为1.29±0.28,二者差异有统计学意义(t=3.81,P=0.01);屈光度治疗前(-1.39±0.69)D,治疗1mo后为(-0.57±0.62)D,平均下降(0.82±0.50)D(t=11.15,P<0.01);角膜前表面曲率治疗前为(37.64±1.68)D,治疗1mo后为(37.14±1.81),下降为(0.50±0.34)D(t=10.02,P<0.01);眼压治疗前平均为(11.84±1.91)mmHg,治疗1mo后为(11.14±1.60)mmHg,二者差异有统计学意义(t=4.02,P<0.01)。结论:降眼压药物—2.5g/L马来酸噻吗洛尔眼液对LASIK术后屈光回退具有显著疗效,其机制可能是通过降低眼压,使前膨的全角膜(包括角膜前、后表面曲率)得到回复而发挥其治疗作用。AIM： To evaluate the curative effect of lOP-lowering medication （2.5g/L timolol eye drops） on regression after laser in situ keratomileusis （LASlK） and to explore its mechanism. METHODS： Twenty-five patients （46 eyes ） with regression after LASlK were treated by 2.5g/L timolol eye drops. The uncorrected visual acuity （UCVA）, bestspectacle corrected visual acuity （BSCVA）, diopter, corneal anterior curvature, intraocular pressure （IOP）, variety value of diopter and corneal anterior curvature were compared before and 1 month after treatment by paired t-test. RESULTS： Compared with pretreatment, the UCVA was increased from 0.63 ± 0.27 to 0.95 ± 0.33 （t = 9.07, P 〈 0.01） at 1 month after therapy, in which 14 eyes （30%） experienced 1 line improvement, 27 eyes （59%） improved 2 or more lines and 5 eyes （11%） were unchanged. The effective rate was 89%. The BSCVA of 1.19±0.27 was increased to 1. 29±0. 28 after therapy, and it showed statistically significant difference （ t = 3.81, P 〈 0.01 ）. The diopter was （ -1.39±0.69） D before treatment and （ -0.57±0.62） D 1 month after treatment, which had statistically significance （t= 11.15, P〈0.01）. The corneal anterior curvature was declined from （37.64±1.68）D to （37.14±1.81 ） D （ t= 10.02, P〈 0.01 ） after treatment. The IOP was （11.84±1.91 ） mmHg before treatment and （ 11.14±1.60） mmHg after treatment, and there was statistically significant difference （ t = 4.02, P 〈 0.01 ）. CONCLUSION： lOP-lowering medication （2. 5g/L timolol eye drops） can restore the whole bulgy-ahead cornea （including anterior curvature and posterior curvature） by decreasing lOP, so it has prominent curative effect to treat the patients with regression after LASIK.

关 键 词：准分子激光原位角膜磨镶术 屈光回退 降眼压药物 噻吗洛尔 机制 

分 类 号：R779.63[医药卫生—眼科] R988.1[医药卫生—临床医学]