玻璃酸钠滴眼液对屈光手术术前患者角膜生物测量参数和视觉质量的影响

Effect of sodium hyaluronate eye drops on corneal biometric parameters and visual quality before refractive surgery

目的观察不同浓度的玻璃酸钠滴眼液对屈光手术术前不同眼表状态的患者的角膜生物测量参数和视觉质量的影响。方法前瞻性随机对照研究。将行屈光手术术前检查并同意参与实验的120例患者(120只眼)根据干眼诊断标准分为正常组(N)(60只眼)及干眼组(D)(60只眼),N组随机分成正常低浓度组(N1)(30只眼)及正常高浓度组(N2)(30只眼),D组随机分成干眼低浓度组(D1)(30只眼)及干眼高浓度组(D2)(30只眼),均取其右眼。低浓度组滴入1滴0.1%玻璃酸钠滴眼液,高浓度组滴入1滴0.3%玻璃酸钠滴眼液。使用Pentancam眼前段分析仪分别在滴眼液前、滴眼液后30 s、2 min和5 min进行4次测量。分析玻璃酸钠滴眼液处理前后角膜曲率(K)、平坦子午线中央3 mm区域内的角膜曲率K1、陡峭子午线中的角膜曲率K2、散光度数(K2-K1)、中央角膜厚度(CCT)测量值的变化,以及其变化程度是否与眼表状态、玻璃酸钠滴眼液的浓度和处理时间相关。使用双通道视觉质量分析系统(OQAS-Ⅱ)分别在滴眼液前、滴眼液后2 min、5 min和10 min进行4次测量。分析玻璃酸钠滴眼液处理前后客观散射指数(OSI)、调制传递函数截止频率(MTF cutoff)和斯特列尔比(SR)测量值的变化,以及其变化程度是否与眼表状态、玻璃酸钠滴眼液的浓度和处理时间相关。结果各组K值、K1值、K2值、K2-K1值波动不显著,CCT值在30 s内波动显著;各组OSI值、MTF cutoff值和SR值波动显著。结论玻璃酸钠滴眼液只对角膜生物测量参数CCT值的影响在30 s内显著,对于视觉质量各测量值的影响均显著;滴入玻璃酸钠滴眼液后短时间内CCT和OSI增大,MTF cutoff和SR减小。

Objective To study the effects of different concentrations of sodium hyaluronate eye drops on corneal biometric parameters and visual quality in patients with different ocular surface states before refractive surgery.Methods A prospective randomized experimental study.According to the diagnostic criteria of dry eyes,the patients were divided into normal group(normal eyes group,N,n=60)and dry eye group(dry eyes group,D,n=60).Group N was randomly divided into normal low concentration group(N1,30 eyes)and normal high concentration group(N2,30 eyes).Group D was randomly divided into two groups:dry eye low concentration group(D1,30 eyes)and dry eye high concentration group(D2,30 eyes).One drop of 0.1%sodium hyaluronate eye drops was given in the low concentration group and one drop of 0.3%sodium hyaluronate eye drops in the high concentration group.The pentancam anterior segment analyzer was used to measure 4 times before and 30 seconds,2 minutes and 5 minutes after eye drops.The changes of corneal curvature(K),corneal curvature K1 in the central 3 mm area of the flat meridian,corneal curvature K2,astigmatism(K2-K1)and central corneal thickness(CCT)in the steep meridian before and after the treatment with sodium hyaluronate eye drops were analyzed,and whether changes were related to the ocular surface state,the concentration of sodium hyaluronate eye drops and the treatment time.Two channel visual quality analysis system(OQAS-Ⅱ)was used to measure 4 times before and 2 minutes,5 minutes and 10 minutes after eye drops.The changes of objective scattering index(OSI),modulation transfer function cutoff frequency(MTF cutoff)and strehl ratio(SR)before and after the treatment of sodium hyaluronate eye drops were analyzed,and whether the degree of change was related to the ocular surface state,the concentration of sodium hyaluronate eye drops and the treatment time.Results The values of K,K1,K2 and K2-K1 did not fluctuate significantly,but the CCT values fluctuated significantly within 30 seconds,and the OSI,MTF cutoff and SR values fluctuated significantly in each group.Conclusions Sodium hyaluronate eye drops only have a significant effect on corneal biometric parameters CCT within 30 seconds,and have a significant effect on visual quality measurements,OSI increases,MTF cutoff and SR decrease in a short time after sodium hyaluronate eye drops are used.