小牛血去蛋白提取物眼用凝胶对LASIK术后早期泪液功能及角膜知觉的影响

The effects of deproteinized calfblood extract eye gel on tear function and corneal sensation at early stage after

目的探讨小牛血去蛋白提取物眼用凝胶在LASIK术后早期对泪液功能和角膜敏感性的影响。方法前瞻陛对照研究。对2011年5月至6月在中山大学眼科中心就诊的108例接受LASIK手术的患者分为两组：A组56例（112只眼）和B组52例（104只眼）。A组术后第一天开始滴用小牛血去蛋白提取物眼用凝胶，每天4次，使用1个月；B组术后第一天开始滴用0．1％玻璃酸钠滴眼液，每天4次，使用1个月，作为对照。分别于术前，术后1周，术后1个月对两组患者进行以下检查：裸眼视力、最佳矫正视力、主观症状评价（包括烧灼感、异物感、干涩感、视疲劳、视物模糊、视力波动）、中央角膜知觉、角膜荧光素染色、泪膜破裂时间和SchirmerI试验。采用SPSS17．0统计软件对数据进行独立样本t检验、配对t检验和Mann—Whitney U检验。结果在随访过程中，未观察到与药物相关的严重并发症。术后1月，A组患者异物感较B组轻，差异有统计学意义（Z=-2．479，P=0．013），其他主观症状两组差异无统计学意义（P〉0．05）；术后1周和1月，两组患者中央角膜知觉比术前均明显下降，差异有统计学意义（P〈0．01），两组之间比较差异无统计学意义（P〉0．05）；术后1周，两组之间泪膜破裂时间（TFBUT）比较差异无统计学意义（t=0．854，P=0．394），术后1月，A组TF—BUT比B组明显延长，差异有统计学意义（t=2．457，P=0．015）；术后1周和1月，两组患者基础泪液分泌量组间比较差异均无统计学意义（P〉0．05）。结论小牛血去蛋白提取物眼用凝胶在LASIK术后早期可缓解患者的主观不适症状，并能使术后泪膜稳定性得到较快恢复。

Objective To investigate the effects of deproteinized calfblood extract eye gel on tear function and corneal sensation at early stage after LASIK. Methods Prospective randomized control study. One hundred and eight patients underwent LASIK were divided into two groups. Fifty six patients （112 eyes） in group A were treated with deproteinized calfblood extract eye gel for 1 month from the 1st post-operative day, four times a day. Fifty two patients （104 eyes） in group B were treated with 0.1% sodium sodium hyaluronate eye drops for 1 month, four times a day, as a control. Uncorrected visual acuity （UCVA）, best corrected visual acuity （BCVA）, subjective symptoms including burning, foreign body sensation, dryness, ocular fatigue, blurring, fluctuate vision, central corneal sensitivity, corneal fluorescein staining, tear film break-up time （TFBUT） and Schirmer I test were evaluated before and 1 week, 1 month after surgery. Comparisons of the variables were performed using independent samples t test, paired t test and Mann-Whitney U test of SPSS 17.0 statistical software. Results No eye in either treatment group showed treatment-related serious adverse events during the follow-up period. Foreign body sensation of group A was lighter than that of group B 1 month after surgery. The difference was statistically significant （Z =-2.479, P =0.013）. Comparisons of other subjective symptoms between the two groups didn＇t have significant difference （P 〉0.05）. Central corneal sensitivity of the two groups was reduced at 1 week and 1 month after operation. The difference was statistically significant （P 〈0.01）. Comparison of central corneal sensi- tivity between the two groups was of no significant difference at all visits （P 〉0.05）. There was no significant difference in TFBUT between group A and group B at 1 week postoperatively （t =0.854, P =0.394）. The average TFBUT of group A was significantly longer than that of group B （t =2.457, P =0.015）. Schirmer I test results were comparable between the two groups at all time points （P 〉 0.05）. Conclusions Deproteinized calfblood extract eye gel can relieve the discomfort symptoms at early stage after LASIK. It can also accelerate the recovery of tear film stability.