bFGF对LASIK术后角膜知觉恢复和角膜神经修复的影响  

Effects of bFGF on corneal perception and nerve recovery after LASIK

作　　者：周远沛[1] 刘苏冰[2] 聂晓丽[2] 买志彬[2] 孙红燕 薛艳玲 曹吉星[1] 

机构地区：[1]郑州大学第二附属医院眼科,河南省郑州市450014 [2]武警河南总队医院眼科,河南省郑州市450052 [3]郑州视光眼科医院,河南省郑州市450046

出　　处：《眼科新进展》2014年第5期454-458,共5页Recent Advances in Ophthalmology

摘　　要：目的研究重组牛碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)对准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后角膜神经修复和角膜知觉恢复的作用。方法将LASIK术后患者随机分入治疗组(treatment group,TG)和对照组(control group,CG)进行临床对比观察,TG组20例(40眼),CG组18例(36眼)。TG组应用r-bFGF滴眼液和眼用凝胶(贝复舒),CG组应用玻璃酸钠滴眼液(爱丽),均为每天4次,连续给药3个月。于术后1周、1个月、3个月、6个月对比两组角膜中央知觉和角膜中央上皮下神经纤维恢复情况。结果术后各时间点两组间裸眼视力比较差异无统计学意义(均为P>0.05),术后6个月时两组裸眼视力均≥5.0。术后1周、1个月、3个月、6个月时角膜知觉TG组为13.67±5.71、21.67±5.77、31.17±7.51、51.33±4.54,CG组为13.50±4.76、19.83±4.64、25.83±11.94、45.83±7.78,术后1周、1个月时两组比较差异无统计学意义(P=0.087、0.094),术后3个月、6个月时TG组优于CG组(P=0.005、0.018),术后6个月时两组角膜知觉均未达到术前水平。术后1周、1个月、3个月、6个月时角膜神经纤维密度TG组为(331.07±410.81)μm·mm-2、(531.53±516.87)μm·mm-2、(1924.73±1160.27)μm·mm-2、(4284.07±2372.23)μm·mm-2,CG组为(319.53±509.17)μm·mm-2、(486.20±611.48)μm·mm-2、(952.87±717.92)μm·mm-2、(2062.87±2417.16)μm·mm-2,术后1周、1个月时两组比较差异无统计学意义(P=0.801、0.072),术后3个月、6个月时TG组角膜神经纤维密度高于CG组(P=0.033、0.000),术后6个月时两组角膜神经纤维密度仍明显低于术前。结论 bFGF对LASIK术后角膜神经修复和角膜知觉恢复具有促进作用。Objective To study the effects of basic fibroblast growth factor （bF- GF） on corneal perception and nerve recovery after laser in situ keratomileusis （LASIK）. Methods The post-LASIK patients were randomly divided into treatment group （20 cases,40 eyes） and control group （18 cases,36 eyes） for clinical compara- tive observation. After LAISK, the r-bFGF eye drops and eye-gel were given to treatment group, and sodium hyaluronate eye drops to control group, 4 times per day for 3 months. The central corneal perception and subbasal nerve recovery of two groups at postoperative 1 week, lmonth, 3 months and 6 months were compared. Results There were no statistical difference in uncorrected visual acuity （UCVA） at each post- operative time point between two groups （ all P 〉 0.05 ）. At postoperative 6 months, UC- VA of two groups were greater than or equal to 5.0 ;At postoperative 1 week, 1 month,3 months ,6 months, the mean central corneal perception of treatment group were 13.67±5.71,21.67 ±5.77,31. 17 ± 7.51,51.33 ±4.54, respectively, and the control group＇ s were 13.50 ± 4.76,19.83 ±4.64,25.83 ± 11.94,45.83 ±7.78, respectively, there was no statistical difference between two groups at postoperative 1 week and 1 month （P = 0. 087,0. 094）, the treatment group at postoperative 3 months and 6 months were greater than the control group （P = 0. 005 ,0. 018 ）, two groups didn＇ t reach to preoperative lev- els at postoperative 6 months. At postoperative 1 week, 1 month, 3 months, 6 months, the mean subbasal nerve density of treatment group were （ 331.07 ± 410. 81 ） μm · mm-2, （531.53 ± 516.87）μm ·mm-2, （ 1924.73 ± 1160.27） μm· mm -2, （4284.07 ±2372.23 ） μm · mm-2, respectively, and the control group were （ 319.53 ± 509.17 ）μm·mm-2, （486.20 ±611.48） μm · mm-2, （ 952.87 ± 717.92） μm ·mm-2, （ 2062.87 ±2417. 16 ） μm ·mm-2, respectively, there was no statistical difference between two groups at postoperative 1 week and 1 month （P

关 键 词：成纤维细胞生长因子 角膜中央知觉 角膜中央上皮下神经 

分 类 号：R779.6[医药卫生—眼科]