自体血清滴眼液对屈光性角膜切削术后角膜上皮愈合的影响

目的：研究自体血清滴眼液对屈光性角膜切削术(PRK)后角膜上皮愈合的影响。

方法：本研究共纳入20例40眼近视及近视散光患者，其中男性9例，女性11例。每例患者随机选取一眼作为研究组应用20%含自体血清的人工泪液，另一眼为对照组应用常规人工泪液。PRK 术中，40眼均于角膜表面居中放置直径8 mm的酒精储槽， 20%的酒精作用20s。术后每天观察直到角膜上皮愈合后，分别于1mo，6mo，12mo进行随访。上皮愈合时间为主要观察指标，并记录裸眼视力(UCVA)，显然验光和混浊度。

结果：两组间术前小瞳检影结果无明显差异。术后1d，2d，3d，研究组平均疼痛评分均显著低于对照组(P<0.05)。术后1d，3d，研究组的平均水平和垂直上皮缺损低于对照组(P<0.05)。研究组上皮完全愈合的平均时间比对照组短约0.7d(3.15±0.366d vs 3.85±0.587d， P=0.00)。

结论：研究表明，应用自体血清滴眼液，通过加速角膜上皮愈合和减轻疼痛，从而缩短视力恢复时间，降低屈光性角膜切削术术后不适、混浊度和感染风险。

Effectiveness of autologous serum eye drops in corneal epithelial healing after photorefractive keratectomy

AIM: To study the effect of autologous serum in corneal epithelial healing after photorefractive keratectomy(PRK).

METHODS:Forty eyes from 20 myopic and myopic-astigmatic patients(9 male and 11 female)were included in this study. One eye of each patient was randomized to receive 20% autologous serum in artificial tears(study group)and one eye received conventional artificial tears(control group). An 8 mm alcohol well was placed centrally in all 40 eyes, and 20% alcohol was applied for 20s during PRK operation. Patients were followed up daily until epithelial closure, and at 1mo, 6mo, and 12mo. Time to epithelial healing was the main outcome measure. Uncorrected visual acuity(UCVA), manifest refraction, and haze were recorded.

RESULTS: The mean preoperative myopic spherical non-cycloplegic(dry)retinoscopy was not significantly different between two groups. The mean pain score in the study group was significantly lower than the control group on days 1, 2 and 3(P<0.05). The mean horizontal and vertical epithelial defects in the study group was lower than in the control group in all follow up exams on days 1 and 3(P<0.05). The mean total time to epithelial healing in the study group was about 0.7d less than in the control group(3.15±0.366d vs 3.85±0.587d, P=0.00).

CONCLUSION: This study demonstrated that using autologous serum eye drops, by accelerating corneal epithelial healing and reducing the pain, which improves recovery time in visual acuity and reduces discomfort, haziness and infection risk after PRK.