噻吗心胺滴眼液治疗准分子激光手术后屈光回退

目的：观察并分析噻吗心胺滴眼液治疗准分子激光手术后屈光回退的疗效，并且初步探讨其作用机制。方法：随机对照研究。选取在乌鲁木齐市眼耳鼻喉专科医院2002 年5 月至2014 年8 月期间行准分子激光手术，术后长期随访中出现不同程度的屈光回退患者51 例（97 眼）。屈光回退度数（-0.95±0.45）D，发生回退时间（3.53±0.72）个月。将这些患者随机分为2 组：噻吗心胺组（48 眼）用0.5%噻吗心胺滴眼液规范治疗，2 次/d；人工泪液组（49 眼）给予人工泪液点眼，3 次/d。治疗时间均为1 个月。所有患者治疗前和治疗后均进行裸眼视力（UCVA）、主觉验光、非接触眼压测量。采用成组t 检验对这2 组患者的各项数据进行比较分析。结果：UCVA（LogMAR）：噻吗心胺组治疗前为0.80±0.25，治疗1 个月后为0.18±0.13，人工泪液组治疗前UCVA为0.78±0.20，治疗1 个月后为0.90±0.85，治疗后2 组差异具有统计学意义（t =6.42，P=0.005）。噻吗心胺组治疗前后眼压下降了1～4 mmHg，平均（1.41±0.39）mmHg，人工泪液组治疗前后眼压下降了-2～1 mmHg，平均（0.52±0.35）mmHg，2 组眼压下降量差异具有统计学意义（t =12.85，P=0.007）。噻吗心胺组治疗前等效球镜度（-0.95±0.42）D，治疗后（-0.13±0.20）D，人工泪液组治疗前等效球镜度（-0.93±0.43）D，治疗后（-0.90±0.42）D，治疗后2 组差异具有统计学意义（t =19.68，P=0.002）。结论：噻吗心胺滴眼液用于治疗准分子激光手术后屈光回退是安全有效的。

The Effect of Timolol Eye Drops on the Refractive Regression of Eyes Treated with Laser Refractive Keratectomy

Objective: To investigate the clinical efficacy of Timololon refractive outcomes in eyes with myopic regression after laser refractive keratectomy and to discuss the function of Timolol eye drops. Methods: Fifty-one patients (97 eyes) with postoperative refractive regression participated in this randomized controlled study. Patients had undergone laser refractive keratectomy and had been followed up for a long time, from May 2002 to August 2014. Patients were divided into two groups and both groups underwent treatment for one month. One group was treated with Timolol eye drops (48 eyes) and the other group was treated with just Tear drops (49 eyes). BCVA, intraocular pressure, and refractive results were measured in the two groups after treatment with the eye drops and the results were compared by t -test. Results: The change in visual acuity for the group treated with Timolol eye drops showed that the mean UCVA improved significantly from 0.80±0.25 to 0.18±0.13, and the mean UCVA changed from 0.78±0.20 to 0.90±0.85 in the group treated with Tear drops. There was a significant difference between the two groups after treatment (t=6.42, P =0.005). The intraocular pressure (IOP) of the Timolol group decreased, with a change of 1-4 mmHg, with an average change of 1.41±0.39 mmHg. The other group had a decreasein IOP of -2-1 mmHg, with an average change of 0.52±0.35 mmHg. There was a significant differencebetween the two groups in decreasement (t=12.85, P =0.007). The manifest refraction of the Timolol group improved from -0.95±0.42 D to -0.13±0.20 D, and the Tear group from -0.93±0.43 D to -0.90±0.42 D. There was a significant difference between the two groups (t=19.68, P =0.002). Conclusions: Timolol eye drops are effective for reducing refractive regression after laser refractive keratectomy for myopia correction.