玻璃酸钠、卡波姆、聚乙二醇、妥布霉素地塞米松对比治疗青光眼合并白内障的临床观察

Clinical Observation of Sodium Hyaluronate versus Carbomer,Polyethylene Glycol,Tobramycin and Dexamethasone in the Treatment of Glaucoma and Cataract

目的：比较玻璃酸钠、卡波姆、聚乙二醇、妥布霉素地塞米松治疗青光眼合并白内障的疗效和安全性。方法：464例青光眼合并白内障患者随机分为A组（116例）、B组（116例）、C组（116例）和D组（116例）。所有患者均采用人工晶状体植入术,术后给予妥布霉素地塞米松眼膏1-1.5 cm,每日3-5次。在此基础上,A组患者给予玻璃酸钠滴眼液1-2滴,每日4次;B组患者给予卡波姆滴眼液1滴,每日3-5次;C组患者给予聚乙二醇滴眼液1-2滴,每日3-5次;D组患者继续给予妥布霉素地塞米松眼膏1-1.5 cm,每日1-3次。各组患者疗程均为1个月。观察各组患者的临床疗效、视力恢复情况、眼表功能情况[干眼症评分、泪膜破裂时间（BUT）、角膜荧光色素染色（CFS）、基础泪液分泌量（SIt）、眼表疾病指数（OSDI）]及不良反应发生情况。结果：总有效率、视力〉0.6的患者例数、BUT、OSDI A组〉B组〉C组〉D组,视力0.3-0.6、0.1-0.3、〈0.1的患者例数和干眼症评分、CFS、SIt A组0.05）。结论：玻璃酸钠治疗青光眼合并白内障的疗效和安全性均优于卡波姆、聚乙二醇、妥布霉素地塞米松,可显著升高视力,改善眼表功能。

OBJECTIVE：To compare the efficacy and safety of Sodium hyaluronate versus Carbomer,Polyethylene glycol,Tobramycin and Dexamethasone in the treatment of glaucoma with cataract. METHODS：464 glaucoma patients with cataract were randomly divided into group A（116 cases）,group B（116 cases）,group C（116 cases）and group D（116 cases）. All patients received intraocular lens implantation;1-1.5 cm to Tramycin and Dexamethasone eye ointment,3-5 times a day. Based on it,group A received 1-2 Sodium hyaluronate eye drops,4 times a day. Group B received 1 Carbomer eye drop,3-5 times a day. Group C received 1-2 Polyethylene glycol eye drops,3-5 times a day. Group D received Tobramycin and dexamethasone eye ointment,1-1.5cm every times,1-3 times a day. They treated for 1 month. Clinical efficacy,recovery of visual acuity and ocular surface functions[dry eye symptom score,tear film break-up time（BUT）,corneal fluorescein staining（CFS）,basal tear secretion（SIt）,ocular surface disease index（OSDI）] and the incidence of adverse reactions in all groups were observed. RESULTS：The total effective rate sorted,patients with visual acuity higher than 0.6,BUT,OSDI by group Agroup Bgroup Cgroup D,with significant differences（P〈0.05）. patients with visual acuity in 0.3-0.6,0.1-0.3 and lower than 0.1,drycye symptom score,CFS,SIt in group A was less than group B,which was less than group C and group D,with significant differences（P〈0.05）. The incidence of adverse reactions in group A was lower than group B,C,D,with significant differences（P〈0.05）,but there was no significant difference in group B,C,D（P〈0.05）. CONCLUSIONS：Sodium hyaluronate shows superior efficacy and safety to Carbomer,Polyethylene glycol,Tobramycin and Dexamethasone in the treatment of glaucoma with cataract,it can significantly improve visual acuity and ocular surface function.