摘要
目的探讨溴芬酸钠滴眼液在经角膜上皮准分子激光角膜表面切削术(Trans PRK)中的应用效果。方法选择2017年4月至2017年9月在新乡医学院第一附属医院眼科行Trans PRK的近视及近视散光患者126例,共240眼。将患者随机分为对照组和观察组,每组63例(120眼)。对照组患者在Trans PRK术前30、15、10、5 min应用普拉洛芬滴眼液滴眼,每次1滴;术后每日4次,每次1滴,连续10 d。观察组患者在Trans PRK术前30、15、10、5 min应用1 g·L^(-1)溴芬酸钠滴眼液滴眼,每次1滴;术后每日2次,每次1滴,连续10 d。术后每天观察患者角膜上皮愈合情况,术后1～4 d评定患者眼部疼痛程度,术后10 d及1、3个月检测2组患者裸眼视力、眼压,并观察术后1、3个月Haze反应及不良反应发生情况。结果术后第1、2天,观察组患者眼部疼痛程度显著轻于对照组(Z=-2. 022、-3. 071,P <0. 05)。术后第3、4天,2组患者眼部疼痛程度比较差异无统计学意义(Z=-1. 890、-1. 276,P> 0. 05)。2组患者术后角膜上皮愈合时间比较差异无统计学意义(t=-1. 109,P> 0. 05)。治疗前2组患者裸眼视力和眼压比较差异无统计学意义(t=1. 214、1. 890,P> 0. 05);治疗后2组患者裸眼视力高于治疗前,眼压低于治疗前(对照组:F=1 089. 665、82. 511,P <0. 05;观察组:F=919. 282、89. 481,P <0. 05)。2组患者术后10 d及1、3个月裸眼视力、眼压比较差异均无统计学意义(裸眼视力:t=-0. 550、0. 703、0. 388,P> 0. 05;眼压:t=0. 965、0. 702、1. 459,P> 0. 05)。对照组患者术后1、3个月Haze反应发生率分别为18. 97%(22/116)和7. 27%(8/110),观察组患者术后1、3个月Haze反应发生率分别为12. 71%(15/118)和4. 42%(5/113),2组患者术后1、3个月Haze反应发生率比较差异无统计学意义(χ~2=1. 719、1. 135,P> 0. 05)。观察组患者在应用溴芬酸钠滴眼液期间,1例1眼出现结膜充血,停药1周后结膜充血症状消失,对照组患者未发生不良反应。结论溴芬酸钠滴眼液可以缓解Trans PRK术后眼部疼痛,且不影响角膜上皮修复。
Objective To investigate the clinical efficacy of bromfenac sodium hydrate ophthalmic solution in trans-epithelial photorefractive keratectomy(TransPRK).Methods One hundred and twenty-six(240 eyes)patients with myopia and myopic astigmatism who were treated with trans-epithelial photorefractive keratectomy(TransPRK)from April 2017 to September 2017 in the First Affiliated Hospital of Xinxiang Medical University were seclected.They were randomly divided into control and observation group,with 63 cases(120 eyes)in each group.At 30,15,10 and 5 min before operation,the patients in the control group were given one drop of pranoprofen eye drops,respectively;and after surgery,four times a day for 10 days,one drop per time.At 30,15,10 and 5 min before operation,the patients in the observation group were treated with one drop of 1 g·L^-1 bromfenac sodium hydrate ophthalmic solution,respectively;and after surgery,twice daily for 10 days,one drop per time.Healing of corneal epithelium was observed every day after operation,the degree of pain of the eyes was observed for four days after the operation.The naked eye eyesight and intraocular pressure were observed at 10 days,one and three months after operation.The Haze reaction and adverse reactions were checked at one and three months after operation.Results At the first and second day after operation,the degree of pain of the eye in the observation group was lower than that in the control group(Z=-2.022,-3.071;P<0.05).However there was no significant difference in the degree of pain of the eye between the two groups at the third and fourth day after operation(Z=-1.890,-1.276;P>0.05).And there was also no significant difference in the time of the epithelial recovery between the two groups(t=-1.109,P>0.05).There was no significant difference in the naked eye eyesight and intraocular pressure between the two groups before operation(t=1.214,1.890;P>0.05).At 10 days,one and three months after operation,the naked eye eyesight was higher and the intraocular pressure was lower than that before operation in the two groups(control group:F=1 089.665,82.511;P<0.05.observation group:F=919.282,89.481;P<0.05).There was no significant difference in the naked eye eyesight and intraocular pressure between the two groups at 10 days,one and three months after operation(naked eye eyesight:t=-0.550,0.703,0.388;P>0.05.intraocular pressure:t=0.965,0.702,1.459;P>0.05).The incidence of Haze reaction was 18.97%(22/116)and 7.27%(8/110)in the control group and 12.71%(15/118)and 4.42%(5/113)in the observation group at one and three months after operation.And there was no significant difference in the incidence of Haze reaction between the two groups at p at one and three months after operation(χ^2=1.719,1.135;P>0.05).In the observation group,only conjunctival congestion occurred in one eye and disappeared one week after withdrawal.Adverse reactions were not found in patients in the control group.Conclusion Bromfenac sodium hydrate ophthalmic solution can relieve eye pain after TransPRK without affecting corneal epithelial repair.
作者
孙玺皓
王保君
杨华
李新民
代志强
袁小艾
SUN Xi-hao;WANG Bao-jun;YANG Hua;LI Xin-min;DAI Zhi-qiang;YUAN Xiao-ai(Department of Ophthalmology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
出处
《新乡医学院学报》
CAS
2018年第12期1068-1072,共5页
Journal of Xinxiang Medical University
基金
河南省科技攻关项目(编号:182102310477)
