0.1％溴芬酸钠滴眼液在SMILE术后的早期疗效

目的 比较0.1％溴芬酸钠滴眼液(普罗纳克滴眼液)与0.3％妥布霉素/0.1％地塞米松滴眼液(典必殊滴眼液)在SMILE术后的抗炎作用及安全性.方法 前瞻性临床对照研究.将2013年9月至2013年10月在中山大学中山眼科中心激光近视眼治疗中心接受SMILE手术的患者60例(120眼)分为2组:普罗纳克组30例和典必殊组30例.普罗纳克组术后第1天开始滴用溴芬酸钠滴眼液,每天2次,使用2周;典必殊组术后第1天开始滴用妥布霉素地塞米松滴眼液,每天4次,使用1周,作为对照.分别于术前,术后1周、1个月及3个月定期观察患者视力、屈光度、眼内压、中央角膜知觉及泪膜破裂时间(BUT)、角膜荧光染色和泪液分泌试验(Schirmer'sⅡtest)及国际眼表面疾病指数(OSDI)等干眼参数变化情况.数据采用重复测量的多因素方差分析和多重比较分析.结果 SMILE术后使用溴芬酸钠滴眼液与使用妥布霉素地塞米松滴眼液,在对术后UCVA、BCVA、角膜中央知觉、干眼参数(BUT、Schirmer'sⅡtest、OSDI)及角膜荧光染色等方面差异均无统计学意义.在SMILE术后1周时,普罗纳克组平均眼内压为(12.51 ±2.45) mmHg,明显低于典必殊组(15.57±2.54)mmHg],差异有统计学意义(F=45.409,P＜0.05).在观察期间,普罗纳克组眼内压保持在一平稳水平,典必殊组停药后眼内压逐渐恢复.结论 SMILE术后应用0.1％溴芬酸钠滴眼液可以达到与妥布霉素地塞米松滴眼液同样的治疗效果,而相对于妥布霉素地塞米松滴眼液,溴芬酸钠滴眼液没有明显的升高眼内压作用,可作为SMILE术后一种既安全又有效的药物.

The short term effects of topical bromfenac sodium hydrate ophthalmic solution eye drops after SMILE

ObjectiveTo compare the efficacy and ocular safety between bromfenac sodium hydrate ophthalmic solution eye drops and topical compound tobramycin eye drops for the treatment of postoperative inflammation and the effect on intraocular pressure in subjects who had undergone small incision lenticule extraction （SMILE）. MethodsIn a prospective， case control study， 30 patients （60 eyes） were treated with bromfenac sodium hydrate ophthalmic solution eye drops 2 times daily for 2 weeks， and 30 patients （60 eyes） were treated with topical compound tobramycin eye drops 4 times daily for 1 week. All subjects had undergone SMILE surgery for myopia correction. Visual quality， intraocular pressure （IOP）， corneal sensitivity， tear film break up time （BUT）， Schirmer′s Ⅱ test， corneal fluorescein staining and ocular surface disease index （OSDI） were assessed preoperatively and at 1 week， 1 month， and 3 months postoperatively. Comparisons of the variables were performed using the repeated measures analysis of variance and multiple comparison analysis with SPSS 19.0 statistical software. ResultsThere was no significant difference between the group treated with bromfenac sodium hydrate ophthalmic solution eye drops and the group treated with compound tobramycin eye drops when uncorrected visual acuity， best corrected visual acuity， corneal sensitivity， BUT， Schirmer′s Ⅱ test， corneal fluorescein staining and OSDI were compared. The IOPcc was significantly higher in the group treated with topical compound tobramycin eye drops （15.57±2.54 mmHg） compared to the group treated with bromfenac sodium hydrate ophthalmic solution eye drops （12.51±2.45 mmHg） and the difference was statistically significant （F=45.409， P<0.05）. ConclusionBromfenac sodium hydrate ophthalmic solution eye drops have the same anti-inflammatory effect as topical compound tobramycin eye drops and do not significantly increase IOPcc during early recovery after SMILE surgery.