普拉洛芬滴眼液联合角膜绷带镜治疗复发性角膜上皮糜烂

Pranoprofen eye drops and bandage contact lens for recurrent corneal erosion syndrome

目的研究普拉洛芬滴眼液联合角膜绷带镜治疗复发性角膜上皮糜烂的有效性。方法选择63例(63眼)复发性角膜上皮糜烂患者,按治疗方法不同分为普拉洛芬组(32例32眼)及对照组(31例31眼)。两组均配戴角膜绷带镜,并每2周更换一次,持续3个月。治疗时两组患眼均使用左氧氟沙星滴眼液和玻璃酸钠滴眼液滴眼,普拉洛芬组还加用普拉洛芬滴眼液滴眼,所有滴眼液均应用3个月。记录两组患眼治疗前及治疗后3个月的最佳矫正视力(BCVA);于治疗后3 d、7 d、1个月及3个月使用视觉模拟评分法(VAS)记录患眼VAS评分;于治疗后3 d、第1个月内的每周及第2个月、第3个月内的每两周行前节OCT检查了解角膜愈合情况,记录角膜愈合时间。对治愈患者进行2年随访,以观察复发情况。结果普拉洛芬组与对照组患者年龄、性别比例、病因分布及既往复发次数比较,差异均无统计学意义(均为P>0.05)。普拉洛芬组患眼治疗前、治疗后3个月BCVA分别为4.39±0.13和4.76±0.11,对照组患眼治疗前、治疗后3个月BCVA分别4.39±0.15和4.75±0.15,两组患眼治疗后BCVA均较治疗前提高,差异均有统计学意义(t=37.350、25.044,均为P<0.05),两组患眼间治疗前、治疗后3个月BCVA差异均无统计学意义(均为P>0.05)。两组患眼组内治疗前、治疗后各随访时间点间VAS评分两两比较,差异均有统计学意义(均为P<0.05)。两组患眼组间治疗前及治疗后3 d、7 d、1个月、3个月VAS评分比较,差异均无统计学意义(均为P>0.05)。普拉洛芬组、对照组患眼角膜愈合时间分别为(6.63±2.76)周、(5.07±1.86)周,差异有统计学意义(t=2.625,P=0.011)。普拉洛芬组患眼复发率(9.38%)与对照组患眼复发率(29.03%)比较,差异有统计学意义(P<0.05)。结论普拉洛芬滴眼液联合角膜绷带镜治疗复发性角膜上皮糜烂患眼的角膜愈合时间略长,但拥有更低的复发率。

Objective To assess the efficacy of pranoprofen eye drops combined with bandage contact lens in the treatment of recurrent corneal erosion syndrome(RCES).Methods Sixty-three patients(63 eyes)with RCES were divided into two groups Pranoprofen group(32 patients,32 eyes)and control group(31 patients,31 eyes).Both groups wore bandage contact lens and changed them every 2 weeks until 3 months.Levofloxacin eye drops and sodium hyaluronate eye drops were used in both groups,while Pranoprofen eye drops were only used in Pranoprofen group.All eye drops were used for 3 months.The best corrected visual acuity(BCVA)were recorded before and 3 months after treatment.Visual analogue score(VAS)were recorded on day 3,7,the first and third month after treatment.Anterior segment OCT was performed for corneal healing check on day 3,weekly in the first month,and every two weeks in the second and third months.The cured patients were followed up for 2 years to observe the recurrence.Results There were no statistically significant differences in age,gender ratio,etiological distribution,and previous recurrence times between the Pranoprofen group and the control group(all P>0.05).The BCVA before and 3 months after treatment was 4.39±0.13 and 4.76±0.11 in Pranoprofen group respectively,while that in the control group was 4.39±0.15 and 4.75±0.15,respectively.The BCVA after treatment in both groups was higher than that before treatment,and the differences were statistically significant(t=37.350,25.044,both P<0.05).There was no significant difference in BCVA between the two groups before and 3 months after treatment(both P>0.05).There were statistically significant differences in VAS at each follow-up time point within the both groups(all P<0.05).There were no statistically significant differences in VAS on day 3,7,1 month and 3 months after treatment between the two groups(all P>0.05).The corneal healing time of patients was(6.63±2.76)weeks and(5.07±1.86)weeks in Pranoprofen group and control group,respectively,and the difference was statistically significant(t=2.625,P=0.011).The recurrence rate of Pranoprofen group(9.38%)was significantly lower than that of control group(29.03%)(P<0.05).Conclusion Pranoprofen eye drops combined with bandage contact lens in the treatment of RCES has a slightly long healing time,but has a low recurrence rate.