左布诺洛尔对LASIK术后角膜前表面曲率的影响

The effect of levobunolol on anterior corneal surface curvature after Laser in-situ keratomileusis

目的比较准分子激光原位角膜磨镶术后不同时期应用盐酸左布诺洛尔对术后角膜前表面曲率变化的影响,以推测其在稳定角膜前表面中的作用。设计病例对照研究。研究对象首次行LASIK手术治疗并连续进行随访的高度近视患者111例(197眼),术前屈光度:-6.00^-9.00 D。方法将以上患者按数字表法随机分为3组,对照组(常规用药组)74眼、治疗组Ⅰ(术后第1天开始局部应用左布诺洛尔组)77眼和治疗组Ⅱ(术后第14天开始局部应用左布诺洛尔组)46眼。分别于术前及术后3个月检测各组患者角膜前表面曲率,术前及术后1、3个月检测各组患者眼压,均进行动态对比分析。主要指标角膜前表面曲率。结果术后3个月与术前比较,各组角膜前表面曲率变化差值分别为:治疗组Ⅰ平均为(6.51±0.91)D,治疗组Ⅱ平均为(6.24±0.96)D,对照组平均为(6.19±1.02)D,治疗组Ⅰ角膜前表面曲率变化差值比对照组大,差异有统计学意义(F=4.04,P=0.045),治疗组Ⅱ与对照组角膜前表面曲率变化差值比较,差异无统计学意义(F=0.02,P=0.760),治疗组Ⅰ与治疗组Ⅱ角膜前表面曲率变化差值比较,差异无统计学意义(F=2.27,P=0.148)。结论高度近视准分子激光原位角膜磨镶术后早期局部应用左布诺洛尔有利于提高术后角膜前表面的稳定性。

Objective To compare the effect of levobunolol hydrochloride eye drops on anterior corneal surface curvature applied in different stage after laser in-situ keratomileusis, to infer the effect of IOP-lowing medication on anterior corneal surface after laser in-situ keratomilersis. Design Case control study. Participants 111 cases （197 eyes） who were treated by laser in-situ keratomileusis and continuously followed up, the diopter of whom before operation was -6.00^-9.00 D. Methods 111 cases （197eyes） were randomly divided into 3 groups. Treatment group I （77 eyes） was treated by levobunolol hydrochloride eye drops from the first day after laser in-situ keratomileusis. Treatment group II （46 eyes） was treated by levobunolol hydrochloride eye drops from the fourteenth day after laser in-situ keratomileusis. Control group （74 eyes） was regularly treated. The anterior corneal surface curvatures were measured before and 3 months after operation and compared between groups. IOP were measured before operation and 1 month, 3 months after operation and compared between groups. Main Outcome Measures The anterior corneal surface curvature. Results The average of the differences between pre- operative and postoperative anterior corneal surface curvatures were （6.51±0.91）D in the treatment group I, （6.24＋0.96）D in the treat- ment group II and （6.19±1.02）D in the control group, respectively. The difference between the treatment group I and the control group was significant （F=4.04, P=0.045）, the difference between the treatment group II and the control group was insignificant （F=0.02, P= 0.760）, the difference between the treatment group I and the treatment group II was insignificant （F=2.27, P=0.148）. Conclusion Lev- obunolol hydrochloride eye drops applied in the early stage after laser in-situ keratomileusis is beneficial to the stability of anterior corneal surface. ]