两种药物对Epi-LASIK术后角膜上皮损伤修复的疗效分析

目的：观察小牛血去蛋白提取物眼用凝胶和重组牛碱性成纤维细胞生长因子(贝复舒)滴眼液对微型角膜刀法准分子激光上皮瓣下角膜磨镶术(epipolis laser in situ keratomileusis， Epi-LASIK)术后角膜上皮修复的影响，评价其疗效及安全性。

方法：接受Epi-LASIK术的120例240眼患者随机分为试验组和对照组，所有患者均从术后第1d晨复查后开始用药。试验组患者用小牛血去蛋白提取物眼用凝胶4次/d，用药1wk； 对照组患者常规应用贝复舒眼液4次/d，用药1wk。术后随访6mo，观察两组患者术后反应、角膜上皮愈合时间、视力、等效球镜度数及角膜上皮下雾状混浊(haze)情况。

结果：试验组与对照组症状体征综合评分于用药前即术后第1d差异无统计学意义(t=1.2912，P>0.05)。试验组与对照组有效率差异无统计学意义(P>0.05)。术后第3d患者症状体征综合评分下降幅度试验组大于对照组，差异有统计学意义(t=2.2366，P<0.05)，说明小牛血去蛋白提取物眼用凝胶起效更快。两组角膜上皮愈合时间差异无统计学意义(t=1.4586，P>0.05)。两组患眼术后视力恢复、等效球镜度数和haze情况差异均无统计学意义(P>0.05)。无药物不良反应事件发生。

结论：Epi-LASIK术后短期应用小牛血去蛋白提取物眼凝胶对角膜上皮愈合有显著促进作用，能明显改善术后刺激症状。它安全且起效时间更短，优于常规治疗，可单独或联合用药，具有较好的应用前景。

Clinical efficacy of two medicines for cornea epithelial healing after Epi-LASIK

AIM:To observe the effect of protein-free calf blood extract eye gel and recombinant bovine basic fibroblast growth factor(bFGF)eye drops on cornea epithelial healing after epipolis laser in situ keratomileusis(Epi-LASIK), and to evaluate the efficacy and safety.

METHODS:One hundred and twenty cases 240 eyes performing Epi-LASIK were randomized into experimental and control group. Sixty cases(120 eyes)were treated as control group with bFGF eye drops for 7 days, four times a day conventionally. Sixty cases(120 eyes )were treated as experimental group with protein-free calf blood extract eye gel for 7 days, four times a day. All the patients of two groups started postmedicating just after the first check on the first day after Epi-LASIK. The postoperative symptoms and signs, time of corneal epithelial recovery, visual acuity, spherical equivalent and corneal subepithelial opacity(haze)were examined at special time in patients of two groups within 6 months.

RESULTS: There was no significant difference in grades of postoperative symptom and sign between experimental and control group before postmedicating on the first day after Epi-LASIK(t=1.2912,P>0.05). There was no significant difference in effective rate between two groups(P>0.05). The experimental group got a more significant decline of grades of postoperative symptom and sign than control group on the 3^rd day postoperatively(t=2.2366, P<0.05), which gave evidence of protein-free calf blood extract eye gel has faster onset of action than bFGF eye drops. There was no significant difference in time of corneal epithelial recovery between two groups(t=1.4586, P>0.05). There was no significant difference in the long-term results of visual acuity, spherical equivalent and haze between two groups(P>0.05). There was no adverse drug effect during treatment.

CONCLUSION: Short-term application of protein-free calf blood extract eye gel after Epi-LASIK has distinct stimulative effect on the healing of corneal epithelium, which can significantly improve the postoperative irritative symptoms. Its effect is faster than conventional treatment. Protein-free calf blood extract eye gel with good safety, can be used alone or in combination, and has better application prospect.