维生素A棕榈酸酯眼用凝胶联合地夸磷索钠滴眼液治疗白内障超声乳化术后干眼的临床研究

Clinical effect of vitamin A palmitate ophthalmic gel combined with diquafosol sodium eye drops in the treatment of dry eye after cataract phacoemulsification

目的:分析维生素A棕榈酸酯眼用凝胶联合地夸磷索钠滴眼液治疗白内障超声乳化术后干眼的临床效果。方法:选取南京医科大学附属无锡人民医院2021年1—12月就诊的白内障超声乳化术后干眼患者118例,按随机数字表法分成对照组59例、观察组59例。对照组接受维生素A棕榈酸酯眼用凝胶治疗,观察组在对照组基础上予地夸磷索钠滴眼液治疗,均治疗8周。对比两组治疗前后泪液浸湿长度、角膜荧光素染色(fluorescein staining,FL)评分、睑板腺腺体完整度、IL-1β与TNF-α水平,比较两组临床疗效与不良反应。结果:两组临床疗效等级比较差异有统计学意义(P<0.05);两组治疗前泪液浸湿长度、FL评分、睑板腺腺体完整度评分、IL-1β、TNF-α水平比较差异均无统计学意义(均P>0.05),治疗后两组泪液浸湿长度均高于治疗前(均P<0.05),FL评分、IL-1β、TNF-α水平均低于治疗前(均P<0.05),且观察组泪液浸湿长度、睑板腺腺体完整度评分均高于对照组(均P<0.05),FL评分、IL-1β、TNF-α水平均低于对照组(均P<0.05);两组不良反应总发生率对比差异无统计学意义(P>0.05)。结论:维生素A棕榈酸酯眼用凝胶联合地夸磷索钠滴眼液治疗白内障超声乳化术后干眼的疗效确切,可减少角膜损伤,增加泪液分泌,保护睑板腺腺体完整度,减轻眼表炎症反应,且安全可靠。

Objective:To analyze the clinical effect of vitamin A palmitate ophthalmic gel combined with diquafosol sodium eye drops in the treatment of dry eye after cataract phacoemulsification.Methods:118 patients with dry eye after cataract phacoemulsification who visited Affiliated Wuxi People′s Hospital of Nanjing Medical University from January to December 2021 were selected,and divided into a control group of 59 cases and a observation group of 59 cases by random number table method.The control group received vitamin A palmitate ophthalmic gel,and the observation group received diquafosol sodium eye drops on the basis of the control group.The treatment time of both groups was 8 weeks.The tear wetting length,corneal fluorescein staining(FL)score,meibomian gland integrity,IL-1βand TNF-αwere compared between the two groups before and after treatment.The clinical efficacy and adverse reactions of the two groups were compared.Results:There was no difference in the level of clinical efficacy between the two groups(P<0.05).There was no significant difference in tear infiltration length,FL score,meibomiangland integrity score,IL-1βand TNF-αlevels between the two groups before treatment(P>0.05).After treatment,the tear wetting length in the two groups were higher than that before treatment,while FL score,IL-1βand TNF-αlevels in the two groups were lower than those before treatment(P<0.05).The tear wetting length,meibomian gland integrity score in the observation group were higher than those in the control group(P<0.05).FL score,IL-1βand TNF-αlevels in the observation group were lower than those in the control group(P<0.05).There was no difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Vitamin A palmitate ophthalmic gel combined with diquafosol sodium eye drops is effective in treating dry eye after cataract phacoemulsification.It can reduce corneal damage and increase tear secretion,protect meibomian gland integrity,and reduce ocular surface inflammatory reaction,and which is safe and reliable.