1g/L溴芬酸钠滴眼液对高度近视散光眼患者行SBK术后疗效分析

Clinical analysis of 1g/L bromfenac sodium eye drops in patients with high myopia astigmatism after sub-Bowman keratomileusis

摘要:

目的：探讨1g/L溴芬酸钠滴眼液对高度近视散光眼患者行前弹力层下准分子激光原位角膜磨镶术(sub bowman keratomileusis，SBK)后的疗效。

方法：选取2012-06/2015-08期间在我院行SBK术的高度近视散光眼(-6.00D≤等效球镜<-11.00D)患者48例96眼，随机分为对照组和试验组，对照组24例48眼，试验组24例48眼； 对照组术后采用氟米龙滴眼液治疗，试验组术后采用1g/L溴芬酸钠滴眼液治疗，两组均持续治疗2wk。于术前，术后1d，1wk，1、3mo分别对患者进行裸眼远视力、眼内压及角膜地形图(K1、K2、散光度数)检查，同时记录视觉症状与体征评分、角膜上皮下雾状混浊(haze)和弥漫性层间角膜炎(diffuse larnellar kerafitis，DLK)发生情况。

结果：两组患者术后不同时间点裸眼远视力、眼内压差异均有统计学意义(P<0.05)。与术前比，两组患者术后1d，1wk，1、3mo时裸眼远视力均改善，术后1、3mo眼内压均降低，差异均有统计学意义(P<0.05)； 与对照组比，试验组患者术后3mo时裸眼远视力改善明显，术后1、3mo时眼内压较低，差异均有统计学意义(P<0.05)。与术前比，两组患者术后1、3mo时K1值、K2值均降低，散光度数升高，差异均有统计学意义(P<0.05)； 两组间术后1、3mo时K1值、K2值、散光度数差异均无统计学意义(P>0.05)。两组患者眼部症状相似，术后均未出现haze现象，试验组患者术后DLK评定状况优于对照组，差异有统计学意义(P<0.05)。

结论：1g/L溴芬酸钠滴眼液与氟米龙滴眼液对SBK术后的疗效类似，但其可有效降低DLK和眼压升高的风险，避免激素所致不良反应，是一种有效的治疗方案。

Abstract:

AIM: To investigate the curative effect of 1g/L bromfenac sodium eye drops on high myopia astigmatism in patients after sub-Bowman keratomileusis.

METHODS: Totally 48 cases(96 eys)of High myopic astigmatism(-6.00DRESULTS: At different time points, uncorrected visual acuity, intraocular pressure, K1 value, K2 value, the degree of astigmatism of the two groups were statistically significant(P<0.05). Compared with preoperative, distance visual acuity increased at postoperative 1d, 1wk, 1 and 3mo; at postoperative 1 and 3mo intraocular pressure decreased(P<0.05). Compared with the control group, the patients in the experimental group had better uncorrected visual acuity at postoperative 3mo and lower intraocular pressure at postoperative 1 and 3mo(P<0.05). Compared with preoperative, K1, K2 value of two groups decreased at postoperative 1 and 3mo, the degree of astigmatism increased(P<0.05). There was no significant difference in K1, K2 and astigmatism between the two groups at postoperative 1 and 3mo(P>0.05). The symptoms and signs of the two groups were similar, and there was no haze phenomenon after operation. The DLK evaluation of the experimental group was better than that of the control group(P<0.05).

CONCLUSION: The 1g/L bromfenac sodium eye drops and fluorometholone eye drops have similar efficacy in the treatment of SBK after operation, but it can effectively reduce the risk of DLK and intraocular pressure, avoid the adverse reactions caused by glucocorticoid, and is an effective treatment plan.