碱性成纤维细胞生长因子对准分子激光原位角膜磨镶术后高阶像差的影响

Effects of basic fibroblast growth factor on higher-order aberrations after laser assisted in situ keratomileusis

目的评价碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF)在准分子激光原位角膜磨镶术(laser assistedin situkeratomileusis,LASIK)后对波前像差的影响。方法选取LASIK手术患者41例,分为实验组(21例,41眼)和对照组(20例,40眼),LASIK术后给予4.88g/L左氧氟沙星滴眼液+1g/L氟米龙滴眼液,每天4次,共2周。实验组给予bFGF;对照组给予玻璃酸钠滴眼液,两组均为每天4次、2个月。观察两组患者术后干眼的症状体征包括模糊感、干涩感、泪膜破裂时间(break up time,BUT)、泪液分泌试验(Schirmer’s test,ST)、角膜荧光染色(fluorescein staining,FL),测量两组患者的视力、像差并进行比较。结果两组术后模糊感、干涩感,ST、BUT无明显差异,bFGF组FL优于对照组(P<0.05)。两组术后裸眼视力差异无统计学意义(P>0.05)。术后两组的球差与术前相比均明显上升(P<0.05),两组间球差值、慧差差异无统计学意义(P>0.05)。术后1个月两组的RMSh与术前相比显著上升(P<0.05),术后2个月时RMSh稍有下降。bFGF组RMSh值比对照组小,但差异无统计学意义(P>0.05)。结论 bFGF能改善LASIK术后干眼,能促进角膜伤口的愈合,对术后总高阶像差的恢复有一定促进作用,但对球差、慧差没有影响。

Objective To analyze the effects of basic fibroblast growth factor（bFGF） on higher-order aberrations after laser assisted in situ keratomileusis（LASIK）. Methods The post-LAISK patients were divided randomly into treatment group（21 cases,41 eyes） and control group（20 cases,40 eyes）.4.88 g/L levofloxacin eye drops and 1 g/L flourometholone eye drops were administrated qid.after the operation.Adding bFGF eye drops to treatment group and hyaluronate sodium eye drops to control group qid.for 2 months.Symptoms and signs included blurring,dryness of eye,fluorescein staining,tear break-up time,Schirmer＇s Test I and wavefront aberrations were measured and compared in the 1st month and 2nd month after LASIK. Results There was no statistical difference between two groups on blurring,dryness of eye,tear break up time（BUT） or Schirmer＇s test（ST）.Fluorescein staining of bFGF group was less than that of control group（P0.05）.There was no difference on naked vision after LASIK（P0.05）.Both treatment group and control group significantly increased the spherical aberration after the operation（P0.05）.And there was no statistical difference between the two groups on spherical and cometray aberration（P0.05）.Total higher-order aberration（RMSh） in the 1st month after the operation（P0.05）,and then decreased slightly in the 2nd month.Treatment group exhibited smaller RMSh than control group,while there was no statistical difference（P0.05）. Conclusions bFGF promoted corneal healing and decreased RMSh partially after LASIK,but had no effects on spherical and cometray aberration.