聚乙烯醇滴眼液与玻璃酸钠滴眼液治疗老年白内障术后干眼症泪膜效果对比

Comparative study on the clinical effect of polyvinyl alcohol eye drops and sodium hyaluronate eye drops in the treatment of dry eye after cataract surgery in the elderly

目的 对比聚乙烯醇滴眼液与玻璃酸钠滴眼液治疗老年白内障术后干眼症泪膜临床效果。方法 回顾性选取2020年3月1日至2021年6月30日收治的老年白内障术后干眼症患者306例,采用随机数字表法分为A组(153例)和B组(153例)。A组给予聚乙烯醇滴眼液治疗,B组给予玻璃酸钠滴眼液治疗,比较2组患者临床疗效、康复指标[泪膜破裂时间(BUT)、基础泪液分泌实验(SIT)]、角膜内皮细胞[角膜内皮细胞密度(ECD)、六角形细胞比例(HEX)、角膜内皮细胞变异系数(CV)]、炎症因子[白细胞介素(IL)-6、IL-33、肿瘤坏死因子α(TNF-α)]和不良反应。结果 2组总有效率比较,差异无统计学意义(P>0.05);治疗后A组患者BUT、SIT均明显高于B组(P<0.05);治疗后A组患者ECD、HEX均明显高于B组,CV明显低于B组(P<0.05);治疗后,2组血清IL-6、IL-33、TNF-α水平均明显低于同组治疗前(P<0.05),2组间血清IL-6、IL-33、TNF-α水平差异均无统计学意义(P>0.05);2组患者治疗期间无明显不良反应。结论 聚乙烯醇滴眼液与玻璃酸钠滴眼液均能有效改善老年白内障术后干眼症症状,但聚乙烯醇滴眼液在增强内膜稳定性、促进泪液分泌和角膜内皮细胞恢复方面效果更佳。

Objective To compare the clinical effect of polyvinyl alcohol eye drops and sodium hyaluronate eye drops in the treatment of dry eye after cataract surgery in the elderly.Methods A total of 306 elderly patients with dry eye after cataract surgery from March 1,2020 to June 30,2021 were enrolled.According to random number table method, they were divided into group A(n=153,polyvinyl alcohol eye drops) and group B(n=153,sodium hyaluronate eye drops).The clinical curative effect, rehabilitation indexes[tear break-up time(BUT),scirmer test(SIT)],corneal endothelial cells[corneal endothelial cell density(ECD),hexagonal cell ratio(HEX),corneal endothelial cell coefficient of variation(CV)],inflammatory factors[interleukin-6(IL-6),interleukin-33(IL-33),tumor necrosis factor-α(TNF-α)]and adverse reactions were compared between the two groups.Results There was no significant difference in total response rate between the two groups(P>0.05).BUT and SIT in group A were significantly higher than those in group B(P<0.05).ECD and HEX in group A were significantly higher than those in group B,while CV was significantly lower than that in group B(P<0.05).After treatment, levels of serum IL-6,IL-33 and TNF-α in both groups were significantly decreased(P<0.05),but there was no significant difference in levels of IL-6,IL-33 and TNF-α between the two groups(P>0.05).There were no obvious adverse reactions in either group during treatment.Conclusions Both polyvinyl alcohol eye drops and sodium hyaluronate eye drops can effectively improve dry eye after cataract surgery in the elderly.However, the former is better in terms of enhancing intimal stability, promoting tear secretion and recovery of corneal endothelial cells.