高度近视患者LASIK术后早期应用噻吗洛尔的效果观察

Effect of timolol on high myopia patients after LASIK

目的探索高度近视患者LASIK术后早期应用噻吗洛尔的临床效果及对视力和屈光回退的影响。方法将我院2019年4月-2019年4月期间收治的高度近视拟行LASIK术治疗的患者79例(158眼)作为研究对象,在此基础上开展本次前瞻性随机对照研究。采用随机数字表法将患者随机分为观察组(n=39例,78眼)和对照组(n=40例,80眼),对照组LASIK术后第8d起增加噻吗洛尔滴眼液点眼,观察组LASIK术后第1d起增加噻吗洛尔滴眼液点眼,均连续点眼2个月,每天1次。比较两组角膜基质厚度、矫正后角膜表面曲率、眼压、等效球镜度、裸眼视力。结果术后3mo和术后6mo,观察组裸眼视力明显优于对照组(t=5.934、6.127,0.654,均P<0.05)。和术后7d比较,两组患者术后1mo、术后3mo、术后6mo角膜基质厚度均明显增加(F=5.645、8.680均P<0.05),但是各时间点两组患者比较则无明显差异(t=0.567、0.421、0.983、均P>0.05)。两组患者术后1mo、术后3mo、术后6mo等效球镜度均在逐渐降低,和同组术后7d比较差异均有统计学意义(F=7.541、12.063均P<0.05),而组间比较发现这三个时间点观察组均明显高于对照组(t=5.983、6.234、6.883,均P<0.05)。术后7d、术后1mo、术后3mo两组比较发现,观察组眼压均明显低于对照组(t=7.235、7.128、6.589,均P<0.05)。结论高度近视患者行LASIK手术后早期应用噻吗洛尔点眼可有效改善患者视力,具有较好的临床效果,且能更好的预防屈光回退的发生。

Objective To explore the clinical effect of timolol on high myopia patients after LASIK and its influence on visual acuity and refractive regression.Method A total of 79 patients(158 eyes)with high myopia who were treated by LASIK in our hospital from April 2019 to April 2019 were selected as the research objects.On this basis,this prospective randomized controlled study was carried out.The patients were randomly divided into observation group(n=39 cases,78 eyes)and control group(n=40 cases,80 eyes)by random number table method.The observation group received timolol eye drops once a day from the first day after LASIK,and the control group received timolol eye drops once a day from the 8th day after LASIK,both of which were continued for 2 months.The corneal stroma thickness,corneal surface curvature,intraocular pressure,equivalent spherical diopter and uncorrected visual acuity were compared between the two groups.Result At 3Mo and 6Mo after operation,the visual acuity of the observation group was significantly better than that of the control group(t=5.934,6.127,0.654,all P<0.05).Compared with 7 days after operation,the corneal stromal thickness of the two groups increased significantly at 1 month,3 months and 6 months after operation(F=5.645,8.680,all P<0.05),but there was no significant difference between the two groups at each time point(t=0.567,0.421,0.983,all P>0.05).The equivalent spherical diopter of the two groups was gradually decreased at 1 month,3 months and 6 months after operation,and the difference was statistically significant compared with that of the same group 7 days after operation(F=7.541,12.063,all P<0.05),while the observation group was significantly higher than the control group at these three time points(t=5.983,6.234,6.883,all P<0.05).The intraocular pressure of the observation group was significantly lower than that of the control group at 7 days,1 month and 3 months after operation(t=7.235,7.128,6.589,all P<0.05).Conclusion Early application of timolol after LASIK can effectively improve the visual acuity of patients with high myopia,and has good clinical effect,and can better prevent the occurrence of refractive regression.