马来酸噻吗洛尔眼液预防高度近视SMILE术后屈光回退的临床研究  

Clinical study of timolol maleate ophthalmic solution for the prevention of refractive regression after SMILE for high myopia

作　　者：陈理 白宁艳 徐浩 吕鹏 王琴 陈玉红 CHEN Li;BAI Ningyan;XU Hao;L Peng;WANG Qin;CHEN Yuhong(The First Clinical College of Zunyi Medical University,Zunyi 563000,China;Department of Ophthalmology,Qianxinan Affiliated Hospital of Zunyi Medical University,Xingyi 562400,China)

机构地区：[1]遵义医科大学第一临床学院,贵州遵义563000 [2]遵义医科大学黔西南附属医院眼科,贵州兴义562400

出　　处：《东南大学学报（医学版）》2024年第4期553-559,共7页Journal of Southeast University(Medical Science Edition)

基　　金：贵州省卫生计生委科学技术基金项目(2018XMSB00017157)。

摘　　要：目的:观察马来酸噻吗洛尔眼液预防高度近视飞秒激光小切口角膜基质透镜取出术(small incision lenticule extraction,SMILE)术后屈光回退的效果。方法:选取2022年11月至2023年7月在遵义医科大学黔西南附属医院眼科行SMILE的76例(134眼)高度近视患者,将患者随机分成观察组与对照组,两组患者术后均予常规滴眼液点眼治疗,观察组在术后第1天加点马来酸噻吗洛尔眼液,每日2次,连续点眼1个月。两组患者均采集术前裸眼视力(uncorrected visual acuity,UCVA)、眼压、等效球镜度(spherical equivalent,SE)、眼轴、中央角膜厚度(central corneal thickness,CCT)和角膜表面曲率(K1、K2),术后1周及1、3、6个月UCVA、眼压、SE、眼轴、CCT、K1、K2。结果:术后6个月观察组UCVA优于对照组(1.21±0.27 vs.1.10±0.16,P<0.05);对照组术后6个月UCVA较术后1周下降(P<0.05);在术后3、6个月两组患者SE差异均有统计学意义[(-0.16±0.50)D vs.(+0.06±0.38)D,P<0.05;(-0.35±0.52)D vs.(-0.04±0.40)D,P<0.05];两组患者SE在术后6个月与术后1周差异具有统计学意义(P<0.05),对照组术后6个月SE均较术后1周回退;在术后1周、1个月两组患者眼压差异具有统计学意义(P<0.05),观察组患者眼压低于对照组;术后不同时间点两组患者角膜曲率K1、K2、CCT及眼轴均无差异(P>0.05),但两组患者术后1、3、6个月CCT与术后1周差异具有统计学意义(P<0.05)。结论:高度近视患者SMILE术后应用马来酸噻吗洛尔眼液可有效抑制房水生成而降低眼压,使角膜在稳定状态下愈合,阻止角膜表面前移,进而起到预防屈光回退的效果。Objective:To study timolol maleate ophthalmic solution in preventing refractive regression after high myopia femtosecond laser small incision lenticule extraction(SMILE).Methods:A total of 76 patients(134 eyes)with high myopia who underwent SMILE surgery in the ophthalmology department of our hospital from November 2022 to July 2023 were selected for inclusion in the study.The patients were randomly divided into an observation group and a control group.Patients in both groups were given conventional eye drops for post-operative treatment.However,the observation group was given some timolol maleate eye drops on the first day after surgery,twice a day,for one month.Before surgery,uncorrected visual acuity,intraocular pressure,spherical equivalent,axial length,and central vision were collected for both groups of patients.Central corneal thickness,and corneal surface curvature K1,K2.uncorrected visual acuity,intraocular pressure,SE,axial length,central corneal thickness and corneal surface curvature K1,K2 were collected at 1 week,1 months,3 months,and 6 months after surgery.Results:There was a statistically significant difference in uncorrected visual acuity between the two groups of patients 6 months after surgery(1.10±0.16 vs.1.21±0.27,P<0.05).The uncorrected visual acuity of the observation group was better than that of the control group.The difference between the uncorrected visual acuity at 6 months after surgery and 1 week after surgery in the control group was statistically significant:the uncorrected visual acuity at 6 months after surgery was lower than that at 1 week after surgery(P<0.05).There were statistically significant differences in spherical equivalent between the two groups of patients 3 months and 6 months after surgery[(-0.16±0.50)D vs.(+0.06±0.38)D,P<0.05;(-0.35±0.52)D vs.(-0.04±0.40)D,P<0.05]:spherical equivalent of the observation group was better than that of the control group.The difference in spherical equivalent between the two groups of patients at 6 months after surgery and 1 week

关 键 词：马来酸噻吗洛尔眼液 高度近视 飞秒激光小切口角膜基质透镜取出术 屈光回退 

分 类 号：R778.11[医药卫生—眼科] R779.63[医药卫生—临床医学]