溴芬酸钠滴眼液应用于高度近视散光眼SBK术后的临床疗效观察  

Clinical efficacy of bromfenac sodium hydrate ophthalmic solution after subbowman keratomileusis for correction of high myopia and myopic astigmatism

作　　者：郎敏[1] 白继[1] 张国伟[1] 陈开建[1] 张怡[1] 阚秋霞[1] 刘李娜[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所眼科,重庆400042

出　　处：《第三军医大学学报》2016年第16期1872-1876,共5页Journal of Third Military Medical University

摘　　要：目的评估高度近视散光眼患者行前弹力层下准分子激光原位角膜磨镶术(sub-bowman keratomileusis,SBK)后应用0.1%溴芬酸钠滴眼液的有效性、安全性和耐受性。方法采用随机对照临床研究方法。收集2012年4月至2013年5月在本科拟行SBK手术的高度近视散光眼(-6.00 D≤等效球镜≤-10.00 D,散光≤-4.00 D)患者,采用随机数字表法分为试验组(37例,72眼)和对照组(36例,72眼)。试验组:术后前3 d用妥布霉素地塞米松眼液,每天4次,第4天换成溴芬酸钠滴眼液,每天2次,至术后1个月;对照组:术后前3 d用妥布霉素地塞米松眼液,每天4次,第4天换成氯替泼诺混悬滴眼液,每天2次,至术后1个月。比较2组患者术前及术后1 d、1周、1个月、3个月、6个月的裸眼视力、屈光状态、眼压及眼部症状等。结果试验组和对照组术后1 d、1周、1个月、3个月、6个月裸眼视力达到术前最佳矫正视力的眼数差异无统计学意义(P>0.05)。术前及术后1 d、1周、1个月、3个月及6个月,试验组与对照组2组间屈光状态比较差异均无统计学意义(P>0.05)。术前及术后1周试验组与对照组眼压差异无统计学意义(P>0.05)。术后1、3、6个月平均眼压值试验组均低于对照组,差异有统计学意义(P<0.05)。试验组无停用溴芬酸钠,对照组中有6眼1个月随访时因激素性高眼压停用氯替泼诺混悬滴眼液并加用降眼压药物。结论高度近视散光眼患者SBK术后应用溴芬酸钠安全、有效、耐受性好,能有效减少激素性高眼压的发生。Objective To investigate the clinical efficacy,safety and tolerability of 0. 1% bromfenac sodium hydrate ophthalmic solution in myopia and astigmatism eyes after sub-bowman keratomileusis（ SBK）.Methods A randomized and controlled clinical study was employed. The patients undergoing SBK for high myopia and myopic astigmatism were enrolled in the study. The myopia degree was- 6. 00 D to- 10. 00 D,and the astigmatism degree was ≤- 4. 00 D. The patients were randomly divided into the experiment group（ bromfenac sodium,72 eyes） and the control group（ loteprednol,72 eyes） with a random number table method. Both groups initially received tobramycin-dexamethasone 4 times a day for 3 d after SBK. Then the patients in the experiment group were given bromfenac sodium twice a day for 1 month,while the patients in the control group were given loteprednol twice a day for 1 month. Visual acuity,refraction,intraocular pressure（ IOP） and corneal symptom were examined before SBK and in 1 d,1 week,1,3 and 6 months after SBK. Results There was no statistically significant difference in the visual acuity and refraction between the2 groups postoperatively（ P 〉0. 05）. There was no statistically significant difference in the IOP between the 2groups in 1 week after SBK（ P 〉0. 05）. The control group had higher IOP than the experiment group in 1,3and 6 months after SBK（ P 〈0. 05）. All patients in the experiment group were no drug withdrawal. But 6eyes in the control group were forced to guide drug withdrawal because of high IOP. Conclusion Bromfenac sodium has good safety,efficacy and tolerability to the patients undergoing SBK for correcting myopia and astigmatism,and can reduce the incidence of high IOP.

关 键 词：前弹力层下准分子激光原位角膜磨镶术 溴芬酸钠 糖皮质激素 屈光手术 眼压 

分 类 号：R778.11[医药卫生—眼科] R969.4[医药卫生—临床医学]