FS—LASIK术后应用溴芬酸钠和氯替泼诺的疗效比较  

Comparison of clinical effects between bromfenac sodium versus loteprednol etabonate following FS-LASIK

作　　者：郎敏 刘莛 陈开建 蒋和芬 朱英 白继 Lang Min;Liu Ting;Chert Kaijian;Jiang Hefen;Zhu Ying;Bai Ji(Department of Ophthahuology,3rd Affiliated Hospital（Research Institute of Surgery）,Army Medical University Chongqing 400042,Chin)

机构地区：[1]陆军军医大学第三附属医院(野战外科研究所)眼科,重庆400042

出　　处：《中华实验眼科杂志》2018年第6期459-463,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：目的 比较质量分数0.1％溴芬酸钠水合物滴眼液与质量分数0.5％氯替泼诺混悬滴眼液应用于飞秒激光制瓣的准分子激光角膜原位磨镶术（FS-LASIK）术后的有效性、安全性和耐受性.方法 采用前瞻性随机对照研究设计.收集2013年12月至2014年12月在陆军军医大学大坪医院接受FS-LASIK手术的近视患者76例152眼,术后7d采用随机数字表法将76例152眼随机分为溴芬酸钠组和氯替泼诺组,各38例76眼.溴芬酸钠组术后第1天开始点用妥布霉素地塞米松滴眼液,每天4次,1周后改为溴芬酸钠滴眼液,每天2次,使用3周;氯替泼诺组术后第1天开始点用妥布霉素地塞米松滴眼液,每天4次,1周后改为氯巷泼诺眼液,每天2次,使用3周.分别于术前,术后1d、1周、1个月、3个月及6个月观察患者视力、屈光度、眼压及眼部体征等情况,比较2个组不同观察时间点间裸眼视力（UCVA）、等效球镜度（SE）和眼压的差异.结果 术后各时间点溴芬酸钠组和氯替泼诺组UCVA达到术前BCVA的眼数百分比比较,差异无统计学意义（x2=8.000,P=0.613）.2个组术后SE在各时间点比较差异有统计学意义（F时间=29.771,P=0.000）,2个组间术后SE比较差异无统计学意义（F分组=1.137,P=0.288）.2个组术后屈光状态早期趋于轻度远视,然后逐渐趋于“0”或者轻度近视状态.2个组术后眼压均低于术前,手术前后不同时间点眼压比较,差异有统计学意义（F时间=87.519,P=0.000）;2个组间眼压比较差异无统计学意义（F分组=1.989,P=0.161）.术后1个月氯替泼诺组有2眼高于20 mmHg（1 mmHg=0.133 kPa）,2眼眼压高于术前5 mmHg.溴芬酸钠组术后1个月眼压均低于18 mmHg,无高于术前5 mmHg的患者.术后随访氯替泼诺组有3例患者因眼压高停药,溴芬酸钠组无停药患者. 结论 FS-LASIK术后序贯使用溴芬酸钠滴眼液患者耐受性好,抗炎安全、有效,并且降低了术后高眼压的发生.Objective To compare the efficacy,safety and tolerability between bromfenac sodium ophthalmic solution 0.1% eye drop and loteprednol etabonate 0.5% eye drop after femtosecond laser in situ keratomileusis （FS-LASIK）.Methods A prospective randomized controlled trail was performed.Seventy-six patients who had been undergone FS-LASIK in Daping Hospital were enrolled from December 2013 to December 2014.They were divided into two groups randomly by using the random number table method.The bromfenac sodium group included 38 patients administered 0.1% bromfenac sodium ophthalmic solution,and the loteprednol etabonate group comprised 38 patients treated with 0.5% loteprednol etabonate.Patients in both groups initially administered tobramycin-dexamethasone four times a day after FS-LASIK for 1 week.Then the patients in the bromfenac sodium group were treated with bromfenac sodium twice a day until 1 month postoperatively.While the patients from the loteprednol etabonate group were treated with loteprednol etabonate twice a day until 1 month after surgery.Visual acuity,refraction,intraocular pressure and ocular manifestation were examined preoperative and 1 day,1 week,1 month,3 months,6 months after FS-LASIK.This study was approved by the medical ethics Committee of Daping Hospital.Results No significant difference was found in the rate of uncorrected visual acuity （UCVA） which achieved to preoperative best corrected visual acuity （BCVA） between the two groups at each time point after operation （x2 =8.000,P =0.613）.There was no difference in spherical equivalent （SE） between the two groups postoperatively （Fgroup =1.137,P =0.288）,but a significant difference was found between the different time points （Ftime =29.771,P =0.000）.Postoperative SE in the two groups tended to have mild hyperopia in the early days,and then gradually tended to ＂ zero＂ or mild myopia.There was a significant difference with intraocular pressure among different time points （Ftime =87.519,P =0.000）,but no significant

关 键 词：飞秒激光制瓣的准分子激光角膜原位磨镶术 溴芬酸钠 氯替泼诺 眼压 角膜屈光手术 

分 类 号：R779.63[医药卫生—眼科]