地夸磷索钠滴眼液对飞秒激光小切口角膜基质透镜取出术(SMILE)后干眼患者的疗效和安全性

Efficacy and safety of diquafosol sodium eye drops in patients with dry eyes after femtosecond laser small incision lenticule extraction

目的探讨30 g·L^(-1)地夸磷索钠滴眼液对飞秒激光小切口角膜基质透镜取出术(SMILE)后干眼患者的疗效和安全性。方法选取2021年8月至2021年11月于河北省眼科医院行SMILE手术的患者23例(46眼)作为研究对象,依据随机数字表法将患者分为地夸磷索钠组11例(22眼)与玻璃酸钠组12例(24眼)。地夸磷索钠组患者在SMILE术后使用30 g·L^(-1)地夸磷索钠滴眼液,每天6次;玻璃酸钠组患者在术后使用1 g·L^(-1)玻璃酸钠滴眼液,每天4次。两组患者均连续治疗1个月。术前及术后1个月观察指标包括:患者裸眼远视力(UDVA)、眼压、屈光状态、SimK值、中央角膜厚度(CCT)、泪河高度(TMH)、泪液分泌试验(SIt)、泪膜破裂时间(BUT)、眼部视觉模拟评分量表(VAS)评分、眼部药物舒适度(ECS)评分、眼表疾病指数问卷调查(OSDI)评分以及药物不良反应的发生情况。结果两组患者术前UDVA、球镜度、柱镜度、眼压、SimK值、CCT差异均无统计学意义(均为P>0.05);眼表功能客观参数TMH、BUT、SIt与眼表功能主观参数眼部VAS评分、ECS评分、OSDI评分差异均无统计学意义(均为P>0.05)。两组患者术后1个月UDVA、球镜度、柱镜度、眼压、SimK值、CCT的差异均无统计学意义(均为P>0.05)。两组患者术后1个月眼表功能客观参数TMH、BUT、SIt差异均无统计学意义(均为P>0.05);两组患者术后1个月眼表功能主观参数方面,地夸磷索钠组的眼部VAS评分明显低于玻璃酸钠组,差异有统计学意义(P<0.05);两组患者术后1个月ECS评分和OSDI评分差异均无统计学意义(均为P>0.05)。术后1个月,地夸磷索钠组患者无药物不良反应发生;玻璃酸钠组发生结膜充血4眼,无其他不良反应发生。结论30 g·L^(-1)地夸磷索钠滴眼液不仅具有和玻璃酸钠滴眼液治疗干眼相似的疗效,而且用药后患者的主观眼部感受更佳,不良反应发生更少。

Objective To investigate the efficacy and safety of 30 g·L^(-1) diquafosol sodium(DS)eye drops in patients with dry eyes after femtosecond laser small incision lenticule extraction(SMILE).Methods A total of 23 patients(46 eyes)who underwent SMILE in the Hebei Provincial Eye Hospital from August 2021 to November 2021 were selected and randomly divided into the DS group(11 patients,22 eyes)and sodium hyaluronate(SH)group(12 patients,24 eyes).Patients in the DS group were treated with 30 g·L^(-1) DS eye drops six times a day for one month after surgery,and patients in the SH group were treated with 1 g·L^(-1) SH eye drops four times a day for one month after surgery.The preoperative and 1-month postoperative uncorrected distance visual acuity(UDVA),intraocular pressure(IOP),refraction,SimK,central corneal thickness(CCT),tear meniscus height(TMH),Schirmer test(SⅠt),tear film break-up time(BUT),ocular visual analogue scale(VAS),eyedrop comfort score(ECS),ocular surface disease index(OSDI),and the occurrence of adverse effects were measured and recorded.Results There were no statistically significant differences between the two groups in preoperative UDVA,spherical power,astigmatic power,IOP,SimK,and CCT(all P>0.05),as well as in the objective parameters of ocular surface function such as TMH,BUT and SⅠt,and the subjective parameters of ocular surface function such as VAS,ECS,and OSDI(all P>0.05).One month after surgery,UDVA,spherical power,astigmatic power,IOP,SimK,and CCT showed no statistically significant difference between the two groups(all P>0.05);the objective parameters of ocular surface function such as TMH,BUT and SⅠt also showed no statistically significant difference between the two groups(all P>0.05);however,for the subjective parameters of ocular surface function,VAS in the DS group was significantly lower than that in the SH group(P<0.05);ECS and OSDI showed no statistically significant difference between the two groups(both P>0.05).One month after surgery,no adverse drug reaction occurred in the DS group;however,conjunctival redness occurred in 4 eyes in the SH group.Conclusion The 30 g·L^(-1) DS eye drops not only present similar efficacy and safety as SH eye drops in the treatment of dry eyes after SMILE,but also provide patients with better subjective ocular perception and fewer adverse reactions.