还原型谷胱甘肽促进LASEK术后上皮修复的临床疗效

Clinical effects of reduced glutathione sodium on postoperative epithelial healing after laser subepithelial keratomilensis

目的：观察还原型谷胱甘肽促进准分子激光上皮下角膜磨镶术（laser subepithelial keratomilensis，LASEK）术后角膜上皮修复的临床效果。方法：随机、双盲、平行对照试验，治疗组65例（130眼）采用天亿＋碘必舒滴眼液（3g／L妥布霉素＋1g／L地塞米松）＋双氯芬酸钠滴眼液，对照组52例（104眼）采用碘必舒滴眼液＋双氯芬酸钠滴眼液。术后观察疼痛、畏光、流泪、异物感4项症状，按无、轻、中、重分别记为0，1，2，3分；术后第1，2，3，5d观察术后反应并评分，第5d开始根据上皮修复情况取镜，记录上皮修复时间。结果：术后第1～3d治疗组术后反应评分为4．1±1．3，3．0±0．8和1．2±0．6，对照组分别为4．1±1．4，3．1±0．8和1．4±0．5，两组差异无显著性；第5d两组评分分别为0．6±0．5和0．8±0．7，差异有显著性；治疗组平均上皮修复时间为5．6±0．7d，对照组为6．2±0．9d，差异有显著性。结论：还原型谷胱甘肽能促进LASEK术后角膜上皮修复，缩短角膜接触镜使用时间。

AIM： To observe the clinical effects of reduced glutathione sodjum （GSH） on postoperative epithelial healing after laser subepithelial keratomilensis （LASEK）. METHODS： In a randomized,double-blind,parallel controlled trial, 65 myopia patients （130 eyes）were topically treated with GSH ＋ TobraDex eye drops （3g/L tobramycin ＋ lg/L dexamethasone） ＋ diclofenac sodium eye drops, 52 myopia patients （104 eyes） were treated as control with TobraDex eye drops ＋ diclofenac sodium eye drops. Clinical observation was followed at 1, 2, 3 and 5 days postoperatively. After observation of pain, photophobia, tears, foreign body sensation four symptoms, according no, mild, moderate and severe, we scored as 0, 1, 2 and 3. Starting from the first five days, we removed corneal contact lenses according to the situation of epithelial healing, and recorded epithelial healing time. RESULTS： At 1, 2 and 3 days postoperatively, treatment group scored of 4. 1 ± 1. 3, 3. 0 ±0. 8 and 1. 2 ± 0. 6 respectively, and the control group were 4.1 ± 1.4, 3.1 ± 0.8 and 1.4 ± 0.5 respectively. There was no significant difference between the two groups. At the fifth day, the two groups scored of 0.6 ±0.5 and 0.8 ± 0. 7, with a significant difference. The average healing time for the epithelial in treatment group was 5.6± 0.7 days, that in control group was 6. 2 ± 0. 9 days, and there was a significant difference. CONCLUSION： Reduced glutathione sodjum can promote epithelial healing after LASEK and shorten the time from soft corneal contact lenses.