无防腐剂自体血清眼水治疗飞秒激光准分子激光角膜原位磨镶术后干眼的临床效果

Clinical effect of preservative-free autologous serum eye drops in the treatment of dry eyes after femtosecond laser-assisted in situ keratomileusis

目的评价无防腐剂自体血清眼水治疗飞秒激光准分子激光角膜原位磨镶术(LASIK)后干眼的临床效果。方法选取2018年8月~2019年8月LASIK后1个月时诊断为中、重度干眼的42例患者作为研究对象,按照随机数字表法将其分为对照组(21例,42眼)和实验组(21例,42眼)。对照组患者采用0.1%玻璃酸钠滴眼液点眼的常规治疗,实验组患者采用无防腐剂自体血清眼水治疗。局部点眼连续治疗28 d,于治疗后7、14、28 d定期随访。对两组患者治疗前后的主观症状[采用眼表疾病指数(OSDI)评价]评分、泪膜破裂时间(BUT)、角膜荧光素染色评分、Schirmer Ⅰ试验结果进行记录分析,并观察两组的不良反应发生情况。结果治疗后14、28 d,实验组患者的OSDI评分均低于对照组,差异有统计学意义(P<0.05)。治疗后14、28 d,实验组患者的BUT长于对照组,差异有统计学意义(P<0.05);治疗后7、14、28 d,实验组患者的角膜荧光素染色评分均低于对照组,差异有统计学意义(P<0.05)。治疗后28 d,实验组的泪液分泌量多于对照组,差异有统计学意义(P<0.05)。两组在治疗过程中均未见不良反应发生。结论无防腐剂自体血清滴眼液可安全、有效地治疗LASIK后干眼患者,能促进角膜上皮修复、改善泪膜质量并有效缓解主观症状。

Objective To evaluate the clinical effect of preservative-free autologous serum eye drops in the treatment of dry eyes after femtosecond laser-assisted in situ keratomileusis(LASIK). Methods Forty-two patients diagnosed with moderate to severe dry eyes from August 2018 to August 2019 one month after LASIK were selected as the research objects, and they were divided into the control group(21 cases, 42 eyes) and experimental group(21 cases, 42 eyes) according to the random number table method. Patients in the control group were treated with 0.1% Sodium Hyaluronate Eye Drops for routine treatment, and patients in the experimental group were treated with preservative-free autologous serum eye drops. Local eye drops were continuously treated for 28 days, and were followed up regularly at 7, 14, and28 days after treatment. The subjective symptom(evaluated by the ocular surface disease index [OSDI]) score, tear break-up time(BUT), corneal fluorescein staining score, Schirmer Ⅰ test results of the two groups of patients before and after treatment were recorded and analyzed. The incidence of adverse reactions of the two groups was observed. Results At 14 and 28 days after treatment, the OSDI scores of the patients in the experimental group were lower than those in the control group, the differences were statistically significant(P<0.05). At 14 and 28 days after treatment, the BUT of the experimental group was longer than that of the control group, and the difference was statistically significant(P<0.05). At 7, 14, and 28 days after treatment, the corneal fluorescein staining scores of the experimental group were lower than those of the control group, and the differences were statistically significant(P<0.05). At 28 days after treatment,the amount of tears secreted in the experimental group was more than that in the control group, and the difference was statistically significant(P<0.05). No adverse reactions occurred during the treatment in two groups. Conclusion Preservative-free autologous serum eye drops can safely and effectively treat dry eye patients after LASIK, promote corneal epithelial repair, improve the quality of tear film and relieve the subjective symptoms.