LASIK术后糖皮质激素应用方案比较

目的　评价LASIK术后糖皮质激素的合理应用时间。方法　采用前瞻性研究 (双盲 ) ,观察行LASIK治疗的 10 0例 (2 0 0眼 )患者 ,根据术后用药不同随机分为试验组、对照组 ,各10 0眼。其中试验组LASIK术后使用典必殊滴眼液一周 ,对照组使用 0 1%氟美童滴眼液一月及托百士滴眼液一周 ,两组患者除术后糖皮质激素应用不同外 ,术前准备、手术方法及术后其他用药均相同 ;为不掩盖症状 ,术后均不使用人工泪液。观察指标包括术前、术后一日、术后三日、术后一周、术后二周、术后一月、术后三月的眼部症状 (包括疼痛、眼干、异物感 )及体症 ,包括裸眼视力、最佳矫正视力及有效球镜、弥漫性角膜基质炎 (DLK)、荧光素染色 (FL)、眼压。等级资料采用非参数独立样本U检验 (Mann -WhitneyTest) ,计量资料采用计量资料统计学方法。结果　术后二周时试验组和对照组DLK存在统计学差异 (P <0 0 5 ) ;角膜荧光素染色 ,试验组二周时恢复术前水平 ,对照组三月时尚未恢复术前水平 ;其他观察指标各时间段差异均无显著意义 (P >0 0 5 )。结论　LASIK术后短期应用强效激素 (一周 )即可获得预期临床效果 ,更有效预防DLK ,以避免长时间使用激素的副作用 ,同时方便患者使用提高治疗依从性

Comparison of cortisteriod eye drops for post LASIK usage

Objective To evaluate the value of corticosteroid eye drops after LASIK for myopia.Methods Prospective and randomized double masked trial.200 eyes were followed up after LASIK operation.There were two groups:TobraDex and Flurometholon.Subjective complaints(include pain,dry eye sensation,foreign body sensation),Uncorrected Visual Acuity,Best Corrected Visual Acuity,DLK,FI,Intraocular Pressure were observed preoperatively and 1 day,3 day,1 week,2 week,1 month,3 month postoperatively.Results At two week postoperatively,DLK was weaker in TobraDex group than that in Flurometholon group ( P <0 05).No significant differences were found in other index at anytime postoperatively.Conclusions Transient use of corticosteroid eye drops after LASIK for myopia is reasonable for good clinical purpose as well as avoiding side effect of cortisteriod.