角膜移植术后使用他克莫司眼液与1%环孢素A眼液眼表疾病评分指数的变化

Changes of Eye Surface Disease Score Index of Tacrolimus Eye Drops and 1% Cyclosporine Eye Drops after Penetrating Keratoplasty

目的:探讨非高危穿透性角膜移植术后使用他克莫司眼液(Tacrolimus, FK506)与1%环孢素A眼液(1% cyclosporine A, 1% CsA)干眼患者标准评分(Standard Patient Evaluation of Eye Dryness, SPEED)、眼表疾病评分(Ocular Surface Disease Index, OSDI)的变化。方法:采用前瞻性病例对照研究,选取非高危穿透性角膜移植手术患者共38例,38眼,按照区组随机原则分为A组(FK506组) 21例、B组(1% CsA组) 17例,术后同时使用抗生素、激素眼液,分别于术前、术后进行裂隙灯观察植片透明度,并完成SPEED、OSDI问卷调查表,结果采用SPSS 19.0软件进行统计分析。结果:A、B组SPEED、OSDI评分在术前、术后1周、1月、3月差异无统计学意义,术后6月SPEED评分差异有显著统计学意义(P = 0.017),OSDI评分差异有统计学意义(p = 0.042)。结论:非高危穿透性角膜移植术后6月使用FK506组舒适度较1% CsA组高,可为非高危角膜移植术后免疫抑制剂的选择提供参考依据。

Objective: To investigate the changes of tacrolimus (FK506) and 1% cyclosporine A, 1% CsA in patients with dry eye (Standard Patient Evaluation of Eye Dryness, SPEED) and Ocular Surface Disease Index, OSDI in patients with dry eye after non-high-risk penetrating corneal transplan-tation. Methods: In the prospective case-control study, 38 patients with non-high-risk penetrat-ing corneal transplantation were selected, 38 eyes were randomly divided into group A (0.1% FK506 group) 21 cases, group B (1% CsA group) 17 cases. Results: The difference of SPEED and OSDI scores in group A and B was not statistically significant in preoperative, postoperative 1 week, 1 month and 3 month, and the difference of SPEED scores in postoperative 6 month was significant (P = 0.017), and the difference of OSDI score was statistically significant (P = 0.042). Conclusion: The comfort of FK506 group was higher than that of 1% CsA group after non-high-risk penetrating corneal transplantation, which could provide reference for the selec-tion of immunosuppressant after non-high-risk corneal transplantation.