质量分数0.1%和0.3%玻璃酸钠滴眼液对FS-LASIK术后干眼泪膜稳定性及视觉质量的影响  

Effect of 0.1% and 0.3% sodium hyaluronic ophthalmic solution on tear film stability and visual quality in FS-LASIK dry eye

作　　者：郑晓红 赵少贞[1] Zheng Xiaohong;Zhao Shaozhen(Tianjin Medical University Eye Hospital, School of Optometry ＆ Ophthalmology, Tianjin Medical University Eye Institute, Tianjin 300384, Chin)

机构地区：[1]天津医科大学眼科医院天津医科大学眼视光学院天津医科大学眼科研究所,300384

出　　处：《中华实验眼科杂志》2018年第5期373-379,共7页Chinese Journal Of Experimental Ophthalmology

摘　　要：目的研究质量分数0.1%和0.3%玻璃酸钠滴眼液对飞秒激光辅助的准分子激光角膜原位磨镶术（FS-LASIK）术后干眼泪膜稳定性及视觉质量的作用。 方法采用前瞻性随机对照研究，选取2016年4月至2017年4月就诊于天津医科大学眼科医院的FS-LASIK术前无干眼、术后1周出现干眼的患者60例60眼，其中轻度干眼患者和重度干眼患者各30例30眼，均取右眼进行分析，患者通过随机数表法随机给予0.1%或0.3%玻璃酸钠滴眼液治疗。在术前、术后1周（点药前和点药后15、30、60、120、180 min）、1个月和3个月使用眼表疾病指数（OSDI）问卷调查、视觉质量分析系统Ⅱ（OQASⅡ）、Keratograph 5M眼表分析仪、角膜荧光素染色等方法进行评估。比较分析FS-LASIK术后3个月内干眼患者局部应用0.1%和0.3%玻璃酸钠滴眼液后泪膜光学质量的动态变化，并分析眼部不适症状（OSDI评分）、非侵入性平均泪膜破裂时间（NIBUT avg）、角膜荧光素染色等参数随时间的变化。结果轻度干眼患者不同时间0.3%玻璃酸钠组较0.1%玻璃酸钠组更能改善OSDI评分（F组别＝10.913，P＝0.003）和角膜染色（P＝0.027）。与术前相比，轻度干眼患者0.1%玻璃酸钠组和0.3%玻璃酸钠组术后1周点药前和点药后多个时间点基础客观散射指数（OSI）均显著增高，差异均有统计学意义（均P〈0.05），术后1个月和3个月与术前比较差异均无统计学意义（均P〈0.05）。重度干眼患者0.1%玻璃酸钠组和0.3%玻璃酸钠组术后1周点药前总OSI较术前显著增高，差异均有统计学意义（P＝0.046、0.060），0.1%玻璃酸钠组点药后总OSI明显下降，点药后各时间点与术前比较差异均无统计学意义（均P〉0.05），术后1个月和术后3个月总OSI较术前显著增高，差异均有统计学意义（P＝0.047、0.017）；0.3%玻璃酸钠组点药后15、30、60、120 min总OSI均较术前增高，差异�Objective This study was to study the effect of 0.1% and 0.3% sodium hyaluronic ophthalmic solution on tear film stability and visual quality of dry eye patients after femtosecond laser-assisted laser in situ keratomileusis （FS-LASIK）.MethodsA prospective randomly controlled study was designed.Pre-surgery normal patients were evaluated again at 1 week after FS-LASIK, 60 mild and severe dry eye patients were enrolled from April 2016 to April 2017 in Tianjin Medical University Eye Hospital.Then 0.1% and 0.3% sodium hyaluronate were randomly given in each dry eye group.Ocular surface disease index （OSDI）, optical quality analysis system Ⅱ（OQASⅡ）, Keratography 5M and corneal staining were performed before operation, 1 week （before instillation and 15, 30, 60, 120 and 180 minutes after instillation）, 1 month and 3 months after operation.This study was approved by the Ethic Committee of Tianjin Medical University Eye Hospital （2015KY-04）. Informed consent was obtained from all subjects after explanation of the nature and possible consequence of the study.ResultsThe 0.3% sodium hyaluronate group was better than 0.1% sodium hyaluronate group in alleviating OSDI score and cornea staining at 3 months in the mild dry eye group （Fgroup=10.913, P=0.003; P=0.027）. Compared with the before operation, the objective scatter index（OSI） was increased at 1 week before instillation and many different time points after instillation in both 0.1% sodium hyaluronate group and 0.3% sodium hyaluronate group, with significant differences between them （all at P〈0.05）, there was no statistically significant difference in OSI at 1 month and 3 months after surgery compared with before surgery in both 0.1% and 0.3% sodium hyaluronate group.In 0.1% sodium hyaluronic group and 0.3% sodium hyaluronic group, the mean value of total OSI at 1 week after surgery were siginifcantly higher than that before surgery （P=0.046, 0.060）. In 0.1% sodium hyaluronate group, the mean values of total OSI at various time poi

关 键 词：玻璃酸钠 干眼 飞秒激光辅助的准分子激光角膜原位磨镶术 泪膜 光学质量 动态变化 

分 类 号：R779.63[医药卫生—眼科]