碱性成纤维细胞生长因子对白内障术后角膜恢复的初步观察  

Basic fibroblast growth factor on corneal recovery after cataract surgery

作　　者：刘铁刚[1] 施玉英[1] 卢建民[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,北京市100730

出　　处：《眼科新进展》2010年第3期271-273,共3页Recent Advances in Ophthalmology

摘　　要：目的观察碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)治疗白内障手术导致角膜水肿和手术源性散光的效果。方法选取施行清亮角膜切口白内障超声乳化吸除术联合人工晶状体植入术后发生角膜水肿的患者80例,随机分为治疗组(bFGF组)和对照组。bFGF组滴用bFGF眼用凝胶(贝复舒眼用凝胶),每天4～6次,每次0.2mL,间隔滴用妥布霉素地塞米松滴眼液(典必殊滴眼液),每天4次。对照组只使用典必殊滴眼液,每天4次。观察2组患者角膜水肿消退时间和术后1个月和3个月角膜内皮细胞密度及角膜散光情况。结果术后角膜水肿平均恢复时间bFGF组为(3.9±1.6)d,对照组为(6.3±2.2)d,2组比较差异有显著统计学意义(t=3.948,P=0.000)。bFGF组角膜内皮细胞密度术后1个月(2067±307)mm-2和3个月(2095±294)mm-2明显优于对照组术后1个月(1793±324)mm-2和术后3个月(1812±311)mm-2,差异均具有统计学意义(均为P<0.05)。术后1个月bFGF组角膜表面非对称指数、角膜表面规则指数明显优于对照组(P<0.05),术后1个月模拟角膜镜读数1、2以及术后3个月2组角膜散光各参数比较差异均无统计学意义(均为P>0.05)。结论常规清亮角膜切口白内障超声乳化吸除术联合人工晶状体植入术后,局部应用bFGF能促进早期角膜水肿的消退,修复受损的手术切口和角膜内皮,减少术后角膜散光,对改善手术复明效果、提高患者生活质量具有良好的治疗意义。Objective To observe the clinical effect of basic fibroblast growth factor （bFGF） on corneal edema and surgically induced astigmatism caused by cataract surgery.Methods Eighty patients with corneal edema caused by clear corneal incision phacoemulsification and intraocular lens implantation were randomly divided into treatment group and control group.The treatment group（bFGF group） was given bFGF eye gel（4 times to 6 times every day,0.2 mL every time） plus tobramycin and dexamethasone eye drops（4 times every day）,while the control group was only treated with tobramycin and dexamethasone eye drops（4 times every day）.And the time of corneal edema subsidence was recorded,the density of corneal endothelial cells and change of corneal astigmatism were observed at 1 month and 3 months after treatment.Results The average time of corneal edema subsidence in the bFGF group and control group were （3.9±1.6）days and （6.3±2.2）days respectively,there was statistical difference（t=3.948,P=0.000）.The density of corneal endothelial cells at 1 month and 3 months after treatment in the bFGF group,which were （2 067±307）mm^-2 and （2 095±294）mm^-2,were obvious higher than that in the control group,which were（1 793±324）mm^-2 and （1 812±311）mm^-2,there were all statistical differences（all P〈0.05）.The surface asymmetry index and surface regularity index in the bFGF group was better than that in the control group at 1 month after treatment（P〈0.05）,but there were no statistical difference in simulated keratoscope reading 1,2 at 1 month and corneal astigmatism at 3 months after treatment between two groups（all P〉0.05）.Conclusions Local application of bFGF after clear corneal incision phacoemulsification and intraocular lens implantation can promote the early corneal edema subsidence,repair the damaged surgical incision and corneal endothelium,reduce the postoperative corneal astigmatism,improve the surgical effects of getting sight and quality of life.

关 键 词：白内障 角膜水肿 散光 碱性成纤维细胞生长因子 

分 类 号：R776.1[医药卫生—眼科]