bFGF与玻璃酸钠治疗FS—LASIK术后干眼与角膜知觉恢复对照研究  

Comparison study in dry eye and recovery of corneal sensitivity between bFGF and sodium hyaluronate after FS-LASIK surgery

作　　者：金颖[1] 王雁[1] 薛超[1] 耿维莉[1] 左彤[1] 

机构地区：[1]天津市眼科医院 天津市眼科研究所 天津市眼科学与视觉科学重点实验室 天津医科大学眼科临床学院,天津300020

出　　处：《中国实用眼科杂志》2016年第8期805-809,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的评估重组牛碱性成纤维细胞生长因子（bFGF）在飞秒激光制瓣的准分子激光原位角膜磨镶术（FS—LASIK）术后常规应用的安全性，观察其治疗术后干眼的临床疗效及在修复角膜知觉方面的作用，并与玻璃酸钠进行对比观察。方法前瞻性对照研究。选取天津市眼科医院在2014年1月113至2014年3月31日FS—LASIK手术患者60例（120只眼），参照随机数字表随机分为实验组和对照组各30例（60只眼）。术后第1d开始，除常规用药外，实验组用bFGF滴眼液每134次，对照组应用0．1％玻璃酸钠滴眼液每134次，连续使用3个月。于手术前及手术后1周、1个月、3个月分别行泪液分泌实验（SIT），泪膜破裂时间（BUT），角膜荧光素染色（FL）评分，角膜知觉检查。统计学采用SPSS17．0统计软件包进行重复测量的方差分析。结果术后1周，实验组和对照组SIT、BUT、角膜知觉检查较术前相比均明显降低，FL评分较术前升高；1个月后开始恢复，至术后3个月时，大致恢复到术前水平。实验组与对照组相比较，SIT、BUT差异无统计学意义（P=0．184，P=0．410），但实验组较对照组BUT恢复快，3个月时恢复水平也较对照组高。FL评分、角膜知觉检查两组差异有统计学意义（P=0．004，P=0．000）。结论bFGF在FS—LASIK术后连续用药3个月具有良好的安全性，能有效缓解眼表的不适，降低干眼的发生，对角膜神经损伤修复和角膜知觉恢复有促进作用。Objective To evaluate the effect of recombinant bovine basic fibroblast growth factor after femtosecond-LASIK in dry eye and corneal sensation recovery, and compare it with sodium hyaluronate. Methods In this prospective control study, a total of 60 patients under FS-LASIK were divided into experimental group and control group. Recombinant bovine basic fibroblast growth factor was used in experimental group while sodium hyaluronate was used in control group 4 times a day for 3 months since 1 day postoperatively. Cochet-Bonnet esthesiomcte, Schirmer I Test （SIT）, tear film break-up time （BUT） and FL scores was used to collect data preoperatively and 1 week, 1 month, 3 months postoperatively, respectively. The results were analyzed with one-way repeated mea- sures ANOVA. Results The cornea perception examination in the experimental group and control group significantly decreased 1 week postoperatively, then began to recover and returned to preoperative level approximately 3 months postoperatively. The SIT, BUT and cornea perception examination significantly decreased in both experimental group and control group while FL scores increased 1 week postoperatively, then began to recover and returned to preoperative level approximately 3 months postoperatively. SIT and BUT had no statistical difference while FL scores and the cornea perception examination had statistical difference, however, experimental group had a faster recovery and returned to a higher level at 3 months compared with control group. Conclusions Recombinant bovine basic fibroblast growth factor has promoting effect in repair of corneal nerve injury and accelerates corneal sensation recovery after LASIK.

关 键 词：准分子激光屈光性角膜手术 重组牛碱性成纤维细胞生长因子 干眼 角膜知觉 神经修复 

分 类 号：R779.6[医药卫生—眼科]