地夸磷索钠联合玻璃酸钠治疗翼状胬肉术后干眼的疗效

Effect of diquafosol sodium combined with sodium hyaluronate on dry eye after pterygium surgery

摘要:

目的：观察3%地夸磷索钠滴眼液联合玻璃酸钠滴眼液在伴泪液分泌不足的翼状胬肉术后早期干眼治疗中的临床疗效。

方法：选取伴泪液分泌不足的翼状胬肉患者64例64眼，均进行翼状胬肉切除联合角膜缘干细胞移植术治疗，术后常规给予抗炎及预防感染治疗。在术后干眼治疗方面，所有患者被随机分为2组，其中观察组使用3%地夸磷索钠滴眼液联合玻璃酸钠滴眼液点眼治疗，对照组使用玻璃酸钠滴眼液点眼治疗。在术后不同时间观察两组患者的泪膜破裂时间(BUT)、荧光素角膜染色(FL)、泪液分泌量(SⅠt)、眼表疾病指数(OSDI)评分、中央角膜厚度(CCT)变化、不良反应及并发症等，并进行比较分析。

结果：两组翼状胬肉患者术前均伴有以泪液分泌不足为主的轻中度干眼。术后2 wk与术前相比，两组患者均表现为BUT缩短，FL评分增高(P<0.05)，两组间BUT对比无差异(P>0.05)。术后4 wk与术后2 wk相比，观察组的BUT延长、OSDI评分降低(均P<0.05)，两组的FL评分均降低(P<0.05)，且观察组优于对照组(P<0.05)。术后1 d，两组患者的CCT均较术前增厚(P<0.05)，两组患者的SⅠt在手术前后均无差异(P>0.05)。

结论：在伴泪液分泌不足的翼状胬肉术后干眼治疗中，3%地夸磷索钠滴眼液联合玻璃酸钠滴眼液修复眼表泪膜的同时，有效减轻患者术后干眼症状，其临床疗效优于单用玻璃酸钠滴眼液。

Abstract:

AIM:To observe the clinical efficacy of 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops in the treatment of dry eyes after pterygium surgery with lacrimal insufficiency.

METHODS: A total of 64 cases(64 eyes)of pterygium patients with lacrimal insufficiency were treated with pterygium resection combined with limbal stem cell transplantation, and they were given routine anti-inflammatory and infection prevention treatment postoperatively. In terms of postoperative dry eye treatment, all patients were randomly divided into two groups. The observation group was treated with 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops, and the control group was treated with sodium hyaluronate eye drops. The break-up time of tear film(BUT), fluorescein(FL), Schirmer's Ⅰ test(SⅠt), ocular surface disease index(OSDI)score, central corneal thickness(CCT)changes, adverse reactions and complications were observed and compared between the two groups at different times postoperatively.

RESULTS: Both groups of pterygium patients were accompanied with mild to moderate dry eyes with insufficient tear secretion preoperatively. At 2 wk after operation, both groups showed shorter BUT and higher FL score compared with those preoperatively(P<0.05). There was no significant difference between the two groups(P>0.05). At 4 wk after operation, BUT in the observation group was prolonged, OSDI score was decreased(both P<0.05), and FL score in both groups was decreased compared with those at with 2 wk after operation(P<0.05). The observation group was better than the control group(P<0.05). At the first day after operation, the CCT of the two groups was thicker than that preoperatively(P<0.05), and there was no significant difference in SⅠt between the two groups before and after operation(P>0.05).

CONCLUSION: In the treatment of dry eye after pterygium surgery with lacrimal insufficiency, 3% diquafosol sodium eye drops combined with sodium hyaluronate eye drops can effectively reduce the postoperative dry eye symptoms, and its clinical effect is better than that of sodium hyaluronate eye drops alone.