摘要
目的观察准分子激光原位角膜磨镶术(LASIK)术后不同时期中央角膜神经的再生情况及神经生长因子(NGF)滴眼液对神经再生的影响。方法采用随机双盲前瞻性对照研究,将35例(70眼)行LASIK的青壮年近视患者随机分为NGF组和对照组,分别检查术前、术后10d、1、3、6个月角膜知觉、泪膜破裂时间(BUT)、泪液分泌量及中央角膜神经密度并进行比较。结果术后10d、1、3、6个月角膜知觉、BUT、泪液分泌量2组间差异均无统计学意义(P>0.05)。术后3个月内角膜神经密度2组间差异无统计学意义(P>0.05),术后6个月NGF组神经密度高于对照组,2组间差异有统计学意义(P<0.05)。结论NGF滴眼液对LAISK术后角膜神经修复有促进作用。
Objective Many studies showed a good effectiveness of nerve growth factor（NGF） on the recovery of corneal sensitivity following the laser in situ keratomileusis（LASIK）. However, no study report verified the regeneration of corneal nerve fiber in the morphology. This study was to determine if topically administration of NGF plays a role in accelerating the reinnervation of central corneal flap nerve after LASIK. Methods A prospective double-masked randomized study was designed. The LASIK was performed in 70 eyes from 30 patients aged 18 -40 years with the equivalent lens -3.00 - -6.00 D. NGF was topically utilized in 36 eyes after LASIK as trail group, and an equal amount of balanced saline solution was used in the other 34 eyes from age and gender-matched patients at the same way in control group. The corneal sensation, tear film break-up time,tear content were examined in 10 days, 1,3 and 6 months after LASIK, and corneal nerve fiber density was counted with confocal scanning laser ophthahnoseopy（ Heidelberg Retina Tomograph Ⅱ Rostock Cornea Module Rostock System）. The Human Research Ethics Committee of this hospital approved the study protocol. Results All the patients completed the treating and following-up procedure according to the trial protocol and were included to the intention-to-treat analysis. No significant difference was found in the comparison of general data and clinical characteristics between two groups（ P 〉 0.05 ）. The corneal sensation was lower in the 10th day after LASIK than before LASIK and gradually recovered after that time in both groups. The BUT after surgery was significantly shorter than before LASIK （ P 〈 0.05 ） and returned to baseline level after 6 months. Nerve fibers in superficial stroma in the hinge of corneal flap were not damaged,however, superficial stromal nerve fibers in the central corneal flap were absent after LASIK. Less regenerating nerve fibers were visualized in corneal stroma within 1 month after LASIK. New nerve fibers from deep stroma formed nets and approached the shallow stroma at 3 months. The number of new fibers in the central corneal flap in NGF group was more than that of control group in the 6th month （ t = 5. 798, P = 0. 000）. Conclusion This study suggests that topical application of NGF may enhance central corneal nerve regeneration after LASIK.
出处
《眼科研究》
CSCD
北大核心
2009年第5期420-424,共5页
Chinese Ophthalmic Research
