两种皮质类固醇激素滴眼液对LASIK术后早期眼压的影响

Effects of Tobramycin Dexamethason and Fluorometholone Eye Drops on Early Post-LASIK Intraocular Pressures

目的探讨准分子激光角膜原位磨镶术(Laser in situ keratomileusis,LASIK)术后,分别使用两种皮质类固醇激素,妥布霉素地塞米松滴眼液(商品名:典必殊)和氟米龙滴眼液(商品名:氟美童)对不同度数近视患者眼压的变化情况。方法近视眼患者120例240只眼,均行LASIK手术。术后根据用药不同分成2组,A组采用妥布霉素地塞米松滴眼液(商品名:典必殊)组;B组采用氟米龙滴眼液(商品名:氟美童),每组患者各60例120只眼。再根据术前屈光度不同将以上两组再分为:低度(0~3.0D)近视组(A1组、B1组);中度(-3.25^-6.0D)近视组(A2组、B2组);高度(≥-6.25D)近视组(A3组、B3组),每组患者各20例40只眼。观察术后1周、2周、1和3个月眼压的变化。结果典必殊组眼压明显大于氟美童组(P<0.05)。典必殊组:低度、中度和高度视力组术后1周高眼压比率分别为27.5%、27.5%、22.5%;术后2周比率明显降低,术后1个月比率稍有增高,术后3个月眼压几乎恢复正常。氟美童组:低度、中度和高度视力组术后1周高眼压比率分别为10.0%、5.0%、7.5%;术后2周、1个月和3个月高眼压例数均为0。结论典必殊与氟美童均能很好的控制LASIK术后炎症反应,氟美童较典必殊更安全,术后早期应监测眼压。

Objective To assess and compare the effects of Tobramycin Dexamethasone and Fluorometholone eye drops on early post-LASIK intraocular pressure.Methods Totally120 postoperative LASIK cases（240 eyes） were divided into two groups（120 eyes each） by the application of Tobramycin Dexamethasone and Fluorometholone eye drops. Based on their preoperative diopters, these two groups were further separated into 3 subgroups： the low myopia group（0^-3. 0 D）,moderate myopiagroup（-3. 25^-6. 0 D） and highmyopia group（≥-6. 25 D）. The changes of the intraocular pressures were observed 1 week, 2 weeks, 1 month and 3 months after the LASIK.Results The intraocular pressure of Tobramycin Dexamethasone groups was significantly greater than that of Fluorometholone groups（P0. 05）. For Tobramycin Dexamethasone groups, one week after the LASIK, the percentages of high intraocular pressure were27. 5%, 27. 5% and 22. 5% respectively. These figures decreased dramatically at 2 weeks and increased slightly at 1 month after the LASIK. In general, the intraocular pressures returned to normal 3 months after the LASIK. For Fluorometholone groups, one week after LASIK, the percentages of high intraocular pressure were 10. 0%, 5. 0% and 7. 0% respectively, which returned to 0 case in other months.Conclusions Both Tobramycin Dexamethasone and Fluorometholone eye drops perform well in controlling post-operation inflammationin. However, compared with Tobramycin Dexamethasone, Fluorometholoneis is safer and has less adverse effects.