目的：观察0.05%环孢素滴眼液联合盐酸奥洛他定滴眼液治疗中重度儿童春季角结膜炎的效果。

方法：采用前瞻性随机对照研究。收集2023年1月至2023年12月我院收治的中重度儿童春季角结膜炎患者，按照随机数字表法分为两组：观察组给予0.05%环孢素联合盐酸奥洛他定滴眼液治疗(0.05%环孢素滴眼液1滴/次，每日4次； 盐酸奥洛他定滴眼液1滴/次，每日2次)； 对照组给予玻璃酸钠联合盐酸奥洛他定滴眼液治疗(玻璃酸钠滴眼液1滴/次，每日4次； 盐酸奥洛他定滴眼液1滴/次，每日2次)，治疗12 wk。比较两组患者治疗前，治疗后4、8、12 wk眼部症状及体征评分。

结果：本研究纳入中重度儿童春季角结膜炎患者42例84眼，所有患者均按时复诊，无失访。观察组21例42眼中男15例，女6例，平均年龄9.00±3.02岁； 对照组21例42眼中男18例，女3例，平均年龄9.38±3.28岁(均P>0.05)。两组患者治疗后4、8、12 wk的眼部症状与体征评分均较治疗前降低(均P<0.05)，且观察组较对照组降低更为显著(均P<0.05)。治疗期间观察组1例患者在用药初期出现一过性眼部轻微刺激感，未予特殊处理，3 d后自行缓解。两组患者治疗期间均未出现眼压升高、角膜感染等严重不良反应。

结论：0.05%环孢素联合盐酸奥洛他定滴眼液可显著改善中重度儿童春季角结膜炎患者眼部症状与体征，治疗中重度儿童春季角结膜炎安全有效。

METHODS:A prospective randomized controlled study was conducted. Patients with moderate-to-severe pediatric vernal keratoconjunctivitis admitted to the hospital from January to December 2023 were collected and divided into two groups according to the random number table method: the observation group was treated with olopatadine combined with 0.05% cyclosporine hydrochloride eye drops \〖1 drop per time of 0.05% cyclosporine eye drops(II), four times a day; 1 drop per time of olopatadine hydrochloric eye drops, twice a day\〗; the control group was treated with sodium hyaluronate combined with olopatadine hydrochloride eye drops(1 drop per time of sodium hyaluronate eye drops, four times a day; 1 drop per time of olopatadine hydrochloric eye drops, twice a day; ). The treatment lasted for 12 wk. The changes in symptom and sign scores of the two groups before treatment, and at 4, 8, and 12 wk after treatment were compared.

RESULTS:Totally 42 children(84 eyes)with moderate-to-severe vernal keratoconjunctivitis were enrolled. All patients returned for follow-up visits on time, with no lossto follow-up. The observation group consisted of 21 patients(42 eyes), with 15 males and 6 females, and the average age was 9.00±3.02 y. The control group consisted of 21 patients(42 eyes), with 18 males and 3 females, and the average age was 9.38±3.28 y(all P>0.05). At 4, 8, and 12 wk after treatment, the ocular symptom and sign scores of both groups decreased compared to those before treatment(all P<0.05), and the decrease in the observation group was more significant than that in the control group(P<0.05). During the treatment period, one patient in the observation group experienced a transient mild ocular irritation at the beginning of medication, which was not treated specially and relieved spontaneously after 3 d. No severe adverse reactions such as elevated intraocular pressure or corneal infection occurred in either group during the treatment period.

CONCLUSION:The combination of 0.05% cyclosporine and olopatadine hydrochlorideeye drops significantly alleviates the clinical symptoms and signs of moderate-to-severe vernal keratoconjunctivitis, showing favorable safety and efficacy in the treatment of moderate-to-severe pediatric vernal keratoconjunctivitis.