卡波姆眼用凝胶联合rhEGF治疗糖尿病患者白内障术后干眼症

Clinical study Carbomer eye gel and rhEGF in treating dry eye after cataract surgery in diabetics

目的:探讨卡波姆眼用凝胶联合重组人表皮生长因子(recombinant human epidermal growth factor,rhEGF)对糖尿病患者白内障术后干眼症的临床疗效。方法:选择糖尿病患者白内障超声乳化术后干眼症160例160眼,随机分为对照组80例80眼和试验组80例80眼。试验组采用卡波姆眼用凝胶联合rhEGF,对照组采用卡波姆眼用凝胶单药治疗。在治疗前、治疗后1,4wk,记录患者干眼症状、泪膜破裂时间(BUT)、泪液分泌试验(SⅠt)及角膜荧光素染色(FL)情况并对眼部安全性进行评价。结果:治疗前试验组和对照组患者眼部主观症状及泪膜功能检测(BUT,SⅠt,FL)比较均无统计学差异(P>0.05)。治疗1wk和4wk后,两组患者眼部主观症状及泪膜功能检测(BUT,SⅠt,FL)与本组治疗前比较差异有统计学意义(P<0.01);试验组和对照组比较差异亦有统计学意义(P<0.05;P<0.01),试验组较对照组BUT明显延长(P<0.01),SⅠt浸湿滤纸长度明显增加(P<0.01)、FL着色密集度明显减少(P<0.01),所有观察病例中未发现明显不耐受药物的患者。结论:卡波姆眼用凝胶能明显改善糖尿病患者白内障术后干眼症状,恢复泪膜稳定性,与rhEGF联合治疗的疗效可能优于其单药治疗。

AIM： To investigate the effect of Carbomer eye gel and recombinant human epidermal growth factor（ rhEGF） on dry eye after cataract surgery in diabetics.METHODS： A total of 160 patients（ 160 eyes） with diabetes undergone phacoemulsification with a diagnosis of dry eyes were randomized divided into two groups,treatment group（ 80 cases,80 eyes） and control group（ 80 cases,80eyes）. In treatment group,the patients were treated by Carbomer eye gel and rhEGF. In control group,the patients were treated by Carbomer eye gel. The subjective dry eye symptoms,tear break-up time（ BUT）,Schirmer I test（ S Ⅰ t） and cornea fluorescein staining（ FL） were observed before treatment,1,4wk after treatment.RESULTS： There was no significant difference between groups before treatment（ P〈0.05）. After treatment at 1,4wk,the subjective dry eye symptoms and the results of three examination（ BUT,S Ⅰ t and FL） in two groups better than those before treatment（ P〈0. 01）. And there was significant difference between experimental group and control group（ P〈0.05; P〈0.01）,the results of BUT,SIt and FL were improved in treatment group better than that in control group（ P〈0.01）. All patients showed good tolerance to Carbomer eye gel and recombinant human epidermal growth factor.CONCLUSION： Carbomer eye gel can relieve the dry eye symptoms of diabetes after phacoemulsification effectively, and it can be more effective to combine Carbomer eye gel with rhEGF at early stage after phacoemulsification.