0.1％溴芬酸钠水合物滴眼液减轻LASEK术后眼部刺激症状的疗效观察

Efficacy observation of 0.1% bromfenac sodium eye drops on relieving the post-LASEK irritative symptoms

目的 探讨0.1％溴芬酸钠水合物滴眼液对减轻准分子激光角膜上皮瓣下磨镶术（LASEK）后眼部刺激症状的疗效.方法 前瞻性随机对照研究.将接受LASEK治疗的屈光不正患者64例随机分为两组,每组选取右眼入组观察,溴芬酸钠组在术前3d及术后1d给予0.1％溴芬酸钠水合物滴眼液2次/d,对照组在术前3d及术后1d给予0.5％酮咯酸氨丁三醇滴眼液4次/d,在术后1、3、5、7d观察眼部刺激症状分级、持续时间、角膜上皮愈合时间以及裸眼视力,对符合正态分布的计量资料组间比较采用￡检验,非正态分布的计量资料比较采用秩和检验,计数资料的比较采用x2检验,重复测量资料采用重复测量设计的方差分析.结果 溴芬酸钠组患者滴用0.1％溴芬酸钠水合物滴眼液眼部无任何不适,对照组患者滴用0.5％酮咯酸氨丁三醇滴眼液,87.5％眼部有刺痛、烧灼感等不适,持续时间2～3s.溴芬酸钠组患者术后眼部刺激症状0、1、2级的比例分别为31.2％（10/32）、68.8％（22/32）、0.0％ （0/32）,与对照组相比差异无统计学意义（Z=-1.625,P=0.104）;溴芬酸钠组术后刺激症状持续时间中位数为2.00d,较对照组缩短（Z=-2.895,P=0.004）;溴芬酸钠组与对照组术后角膜上皮愈合时间中位数均为5.00d,差异无统计学意义（Z=-1.723,P=0.085）,两组术后1d、3d、5d、1个月、3个月裸眼视力差异均无统计学意义（F=2.086,2.180,2.869,0.143,0.401;P＞0.05）.结论 0.1％溴芬酸钠滴眼液能有效缓解LASEK术后眼部刺激症状,患者的耐受性与使用便利性比0.5％酮咯酸氨丁三醇滴眼液更好.

Objective To observe the efficacy of bromfenac sodium eye drops on relieving the irritative symptoms after LASEK surgery.Methods Sixty-four people who had received LASEK surgery were randomly divided into two groups,observing the right eye for each group,group A was given 0.1% bromfenac sodium eye drops twice a day in three days before surgery and one day after surgery; group B was given 0.5% ketorolac tromethamine （acular） eye drops four times a day in three days before surgery and on day after surgery.In the 1st,rd,5th and 7th day after surgery,irritative symptoms grade,duration of irritation,time for corneal epithelial healing,and uncorrected visual acuity were observed and compared between the two groups.Results 0.1% no discomfort in group A with bromfenac sodium eye drops was observed while 0.5% ketorolac tromethamine eye drops caused tingling,burning discomfort that lasted for 2-3 seconds in 16 of the 28 subjects （87.5%）.No significant difference was observed between the irritation grades of group A and B （Z =-1.625,P =0.104） ; the duration of irritative symptom was significantly shorter in group A than that in group B （Z =-2.895,P =0.004）.No significant difference was observed between the time of healing and visual acuity recovery of the two groups.Conclusion 0.1% bromfenac sodium eye drops can effectively relieve the post-LASEK irritative symptoms,and it is better tolerated than 0.5% ketorolac tromethamine eye drops.