非甾体抗炎药对于LASIK术后干眼的疗效分析  

Efficacy of non-steroidal anti-inflammatory drugs for dry eye after laser-assisted in situ keratomileusis

作　　者：马玲[1,2] 杜显丽[2] 陈敏[2] 

机构地区：[1]青岛大学临床医学院临床医学系,中国山东省青岛市266071 [2]山东省眼科研究所,中国山东省青岛市266071

出　　处：《国际眼科杂志》2012年第6期1069-1072,共4页International Eye Science

摘　　要：目的:探讨LASIK术后加用非甾体抗炎药对缓解术后干眼症的疗效。方法:选择2010-10/11在青岛眼科医院行LASIK手术的近视66例132眼。并在术后常规用药基础上,左眼只使用人工泪液,右眼加用1g/L普拉洛芬滴眼液,进行自身对照研究。根据右眼滴用非甾体抗炎药频率不同,分为A组:4次/d(74眼)、B组:6次/d(58眼)。分别于术前、术后10d;1mo进行主观问卷调查、基础泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素钠染色(FL)、虎红染色、角膜表面不规则指数(ISV)、角膜表面非对称性指数(IVA)。并对几组结果分别进行统计学分析。结果:与对照眼比较,除ISV和IVA之外,A,B两组组内比较术后10d及1mo其余指标差异均有统计学意义。A,B两组组间比较,术后10dBUT和虎红染色的差异有统计学意义(P<0.05)。术后1mo各项指标差异无统计学意义。结论:角膜地形图ISV和IVA对于LASIK术后干眼的诊断具有意义,但对于术后干眼治疗的疗效评价缺乏特异性;在LASIK术后加用非甾体抗炎药,能通过减轻术后炎症反应、延长泪膜破裂时间而有效的缓解术后早期的干眼症状;增加非甾体抗炎药的滴用频率并不能明显增加药效。AIM： To evaluate the efficacy of non-steroidal anti-inflammatory drugs to relieve the symptoms of dry eye after laser-assisted in situ keratomileusis （LASIK）. METHODS： Sixty-six patients （132 eyes） were involved and made a self-controlled study in Shandong Eye Institute from November to October 2010. Based on conventional treatment, only artificial tears drops was used for the left eye, and 1g/L Pranoprofen drops was added for the right eye. According to the frequency of the drops, they were divided into two groups, including group A （4 times/day）and group B （6 times/day）. Subjective symptoms, Schirmer test（SⅠt）, tear break-up time（BUT）, fluorescein staining（FL）, rose bengal staining, index of surface variance（ISV） and vertical asymmetry（IVA） were recorded and made a statistical analysis respectively before and 10 days, 1 month after surgery. RESULTS： Compared with the control eyes ,there was a statistically significant difference in all the indicators except ISV and IVA of 10 days after the surgery, and except FL, ISV and IVA of 1 month after the surgery in both group A and group B.There was a statistically significant difference in BUT and rose bengal staining of ten days after the surgery between group A and group B（P0.05）. There was no statistically significant difference in indicators 1 month after the surgery. CONCLUSION：The tendency of ISV and IVA from topography shows a great leap but less specificity to evaluation of dry eye after LASIK. Add with 1g/L Pranoprofen drops after LASIK surgery could relief the symptoms of the dry eye effectively though reduce the inflammation and prolong the tear BUT. Increasing the frequency of the non-steroidal anti-inflammatory drugs could not significantly raise the efficiency of the drugs.

关 键 词：准分子激光角膜原位磨镶术 干眼症 普拉洛芬 疗效 

分 类 号：R779.63[医药卫生—眼科]