个体化用药方案预防LASIK术后屈光回退回顾性研究  

A retrospective study of personalized-medication-plan to prevent regression after LASIK

作　　者：牟章兵 朱晋 李旭松 谢艾芮 莫静 

机构地区：[1]成都363医院眼视光部,成都610041

出　　处：《中国实用眼科杂志》2009年第8期838-841,共4页Chinese Journal of Practical Ophthalmology

基　　金：四川省卫生厅科研课题（070190）

摘　　要：目的研究个体化用药方案对LASIK术后屈光回退的预防作用，探讨其作用机制。方法收集LASIK手术患者208例416只眼，分为个体化用药组和传统用药组，对两组术后6月的屈光回退比率进行X^2检验；两组术后1d、1月、3月、6月的裸眼视力、屈光度和角膜曲率分别进行成组t检验。结果术后6月回退率个体化用药组为0．53％；传统用药组为3．54％，个体化用药组低于传统用药组（X^2=4．4286，P〈0．05）。两组术后1d裸眼视力差异无统计学意义（t=0．68，P〉0．5），术后1月和3月个体化用药组低于传统用药组（t=2．73，P〈0．01；r=2，34，P〈0．05），术后6月个体化用药组高于传统用药组（t=2．57，P〈0．05）。两组术后1d过矫屈光度差异无统计学意义（t=0．33，P〉0．05），以后两组屈光度均随时间延长而降低，其中个体化用药组下降较慢，各时间点均高于传统用药组（t=4．47，P〈v0．01；t=7．43，P〈0．01；t=5．53，P〈0．01）。两组术后1d角膜曲率差异无统计学意义（t=1．16，19〉0．05），以后两组角膜曲率均随时间延长而增加，其中个体化用药组增加较慢，各时间点均低于传统用药组（t=2．65，P〈0．01；t=3．36，P〈0．01；t=3．00，P〈0．01）。结论个体化用药方案可增加LASIK术后屈光度和角膜曲率的稳定性，较少屈光回退的发生率，是预防屈光回退的一种有效手段。Objective To study the preventive effect of personalized-medication-plan on regression after laser in situ keratomileusis （LASIK） and to explore its mechanism. Methods This retrospective study included 416 eyes of 208 patients that had undergone LASIK. The eyes were divided into two groups according to medication-plan：personalized-medication-group and traditional-medication-group. We compared the regression rate between two groups at 6 months after operation by X ^2-test. At the same time,we compared the uncorrected visual acuity （UCVA）, diopter and corneal curvature between two groups at 1 day, 1 month, 3 months and 6 months after operation separately by t-test. Results The regression rate of personalized-medication-group was lower than traditional-medication-group （X^2= 4.4286, P 〈 0.05）. There was no statistical difference of UCVA between two groups at 1 day after operation （t =0.68, P =0.4938 ）. The UCVA of personalized-medication-group was lower than traditional-medication-group at 1 month and 3 months （t =2.73,P 〈 0.01;t =2.34, P 〈 0.05） and higher than traditional-medication-group at 6 months （t =2.57, P 〈0.01 ） after surgery. There was no statistical difference of diopter between two groups at 1 day after operation （ t =0.33 ,P =0.7445）. Afterwards,the diopter of two groups all decreased. But the diopter of personalized-medication-group decreased slowly and it was higher than traditional-medication-group at other time-point （ t =4.47, P 〈0.0001 ; t =7.43,P 〈0.0001 ; t =5.53 ,P 〈0.0001 ）. The corneal curvature of two groups had no statistical difference at 1 day after operation （ t =1.16,P =0.2484） and it all increased as time went. But it increased slowly in personalized-medication-group and it was lower than traditional-medication-group at other time-point （ t =2. 65, P =0.0084; t =3.36, P =0.0009 ; t =3.00, P =0.0029 ）. Conclusions The personalized-medication-plan could reduce the regression rate after LASIK by strengthening the stability of diopte

关 键 词：准分子激光原位角膜磨镶术 屈光回退 预防 药物 

分 类 号：R779.6[医药卫生—眼科] R778.11[医药卫生—临床医学]