马来酸噻吗洛尔滴眼液对高度近视眼LASIK术后近视回退的影响

目的探讨马来酸噻吗洛尔滴眼液在防治高度近视眼准分子激光原位角膜磨镶术(1aser in situ keratomileusis,LASIK)后屈光回退中的作用。方法选取接受LASIK治疗的高度近视眼患者术后第1天主觉验光等效球镜屈光度在0～-0.75D患者78例(78眼),随机分为研究组39例(39眼)和对照组39例(39眼)。对照组术后常规应用抗生素滴眼液滴眼10d和皮质类固醇滴眼液滴眼1个月。研究组术后除常规用药外,术后第1天增加使用马来酸噻吗洛尔滴眼液每天2次滴眼1个月。术前、术后10d、1个月、3个月进行眼压和主觉验光检查,OrbscanⅡ测量角膜后表面前移量(Diff差值)。结果研究组术后10d、1个月、3个月眼压分别为(9.61±2.90)mmHg(1kPa=7.5mmHg)、(9.97±2.50)mmHg、(10.61±2.90)mmHg,与对照组比较(11.69±2.60)mmHg、(11.99±3.07)mmHg、(10.92±2.65)mmHg],术后10d、1个月差异均有统计学意义(均为P<0.05),术后3个月差异无统计学意义(P>0.05)。研究组术后10d、1个月和3个月角膜后表面Diff差值分别是(9.56±6.66)μm、(10.72±6.70)μm和(14.11±4.66)μm,对照组分别为(19.57±7.76)μm、(20.24±7.37)μm和(20.10±6.98)μm,两组比较差异有显著统计学意义(F=34.236,P=0.000);两组术后同时间点Diff差值比较,差异均有统计学意义(均为P<0.05)。研究组术后10d、1个月和3个月时等效球镜屈光度分别为(-0.46±0.28)D、(-0.61±0.34)D和(-0.75±0.21)D,对照组分别为(-0.67±0.23)D、(-0.93±0.23)D和(-1.05±0.29)D,两组术后同时间点比较差异均有统计学意义(均为P<0.05)。结论高度近视眼LASIK术后早期应用马来酸噻吗洛尔滴眼液能阻滞角膜后表面前移,降低近视屈光度,是预防高度近视眼LASIK术后屈光回退的一种有效方法。

Effect of timolol on myopia regression in high myopia after LASIK

Objective To study the effect of timolol eye drops on myopia regression in high myopia after LASIK. Methods This prospective randomized study included 78 patients(78 eyes) with spherical equivalent refraction ranged from 0 to -0.75 D at 1 day after LASIK for high myopia.The patients were randomly divided into control group (39 cases,39 eyes) and study group (39 cases,39 eyes).Control group received antibiotic eye drops for 10 days and corticosteroid eye drops for 1 month after operation.Study group received antibiotic and corticosteroid eye drops in the same procedure as that of control group,in addition,timolol was administered topically twice daily after operation for 1 month.Intraocular pressure (IOP) and spherical equivalent refraction were obtained before operation and 10 day,l month and 3 months after operation,and the amount of forward shift of the posterior corneal surface (difference-diff) was measured by Orbscan Ⅱ. Results IOP at postoperative 10 days,1 month and 3 months in study group were (9.61±2.90)mmHg(1 kPa=7.5 mmHg),(9.97±2.50)mmHg and (10.61±2.90)mmHg,which in control group were (11.69±2.60)mmHg,(11.99±3.07)mmHg and (10.92±2.65)mmHg,there were statistical differences at postoperative 10 days and 1 month between two groups(both P<0.05).Difference-diff value at postoperative 10 days,1 month and 3 months in study group were (9.56±6.66)μm,(10.72±6.70)μm and (14.11±4.66)μm,respectively,which in control group were (19.57±7.76)μm,(20.24±7.37)μm and (20.10±6.98)μm,respectively,there was significant difference between two groups(F=34.23,P=0.000),and there were statistical differences at postoperative different time points between two groups(both P<0.05).The refraction (spherical equivalent) at postoperative 10 days,1 month and 3 months in study group were (-0.46±0.28)D,(-0.61±0.34)D and (-0.75±0.21)D,respectively,which in control group were (-0.67±0.23)D,(-0.93±0.23)D and (-1.05±0.29)D,respectively,there were significant differences at postoperative different time points between two groups (both P<0.05). Conclusion Administering timolol eye drops early in high myopia after LASIK postoperatively can reduce the forward shift distance of the posterior corneal surface and myopia refraction.It is a better way to prevent myopia regression in high myopia after LASIK.