LASIK术后不同时间应用噻吗洛尔对高度近视屈光回退的影响
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摘要
目的:观察LASIK术后不同时间应用噻吗洛尔对高度近视患者屈光回退的影响。方法:前瞻性研究。选取2015-08/2016-08收入我院的高度近视患者90例180眼为研究对象,随机分为对照组和观察组,各45例90眼,两组患者术后均常规使用抗生素滴眼液7d,对照组患者于术后第8d开始使用噻吗洛尔滴眼液,观察组患者于术后第1d开始使用噻吗洛尔滴眼液。分别于术前、术后7d,1、3、6mo检测并比较两组患者裸眼视力、等效球镜度、眼压、角膜表面曲率、角膜基质厚度。结果:术后不同时间点两组患者裸眼视力、等效球镜度均有差异(P<0.05),且术后6mo,观察组患者裸眼视力、等效球镜度均优于对照组(0.03±0.01 vs 0.08±0.01; 0.15±0.33D vs-0.17±0.36D;均P<0.05)。术后不同时间点两组患者角膜基质厚度和角膜表面曲均无组间差异性(P>0.05)。术后7d,1、3mo观察组患者眼压均明显低于对照组(均P<0.05),术后6mo两组患者眼压趋于稳定。结论:LASIK术后早期应用噻吗洛尔能有效降低眼压,并保持相对较长时间眼压稳定,阻止角膜膨隆,进而起到预防屈光回退的效果。
?AIM:To observe the effect of timolol on refractive regression after high myopia surgery at different time points in LASIK operation.?METHODS: Prospective study. Totally 180 eyes of 90 patients with high myopia who were admitted to our hospital from August 2015 to August 2016 were randomly divided into control group and observation group. Each group had 45 cases and 90 eyes. Both groups were treated with loxacin eye drops and tobramycin dexamethasone eye drops for 1 wk. The control group was treated with timolol eye drops 7 d after operation, and the observation group was treated with timolol eye drops 1 d after operation. The uncorrected visual acuity, spherical equivalent, intraocular pressure, corneal surface curvature and corneal stroma thickness were measured and compared before and 7 d, 1, 3 and 6 mo after operation.?RESULTS: There were differences in naked vision and spherical equivalent between the two groups at different time points after operation(P<0.05). At 6 mo after operation, the naked vision and spherical equivalent of the observation group were better than those of the control group(0.03±0.01 vs 0.08±0.01; 0.15±0.33 D vs-0.17±0.36 D;all P<0.05). There was no difference in corneal stroma thickness and corneal surface curvature between the two groups at different time points(P>0.05). The intraocular pressure of the observation group was significantly lower than that of the control group at 7 d, 1 and 3 mo after operation(all P<0.05). The intraocular pressure of the two groups tended to be stable at 6 mo after operation.?CONCLUSION: Early application of timolol after LASIK can effectively reduce intraocular pressure, maintain relatively long-term stability of intraocular pressure, prevent corneal swelling, and thus prevent refractive regression.
?AIM:To observe the effect of timolol on refractive regression after high myopia surgery at different time points in LASIK operation.?METHODS: Prospective study. Totally 180 eyes of 90 patients with high myopia who were admitted to our hospital from August 2015 to August 2016 were randomly divided into control group and observation group. Each group had 45 cases and 90 eyes. Both groups were treated with loxacin eye drops and tobramycin dexamethasone eye drops for 1 wk. The control group was treated with timolol eye drops 7 d after operation, and the observation group was treated with timolol eye drops 1 d after operation. The uncorrected visual acuity, spherical equivalent, intraocular pressure, corneal surface curvature and corneal stroma thickness were measured and compared before and 7 d, 1, 3 and 6 mo after operation.?RESULTS: There were differences in naked vision and spherical equivalent between the two groups at different time points after operation(P<0.05). At 6 mo after operation, the naked vision and spherical equivalent of the observation group were better than those of the control group(0.03±0.01 vs 0.08±0.01; 0.15±0.33 D vs-0.17±0.36 D;all P<0.05). There was no difference in corneal stroma thickness and corneal surface curvature between the two groups at different time points(P>0.05). The intraocular pressure of the observation group was significantly lower than that of the control group at 7 d, 1 and 3 mo after operation(all P<0.05). The intraocular pressure of the two groups tended to be stable at 6 mo after operation.?CONCLUSION: Early application of timolol after LASIK can effectively reduce intraocular pressure, maintain relatively long-term stability of intraocular pressure, prevent corneal swelling, and thus prevent refractive regression.
引文
1孙红燕,刘苏冰,马小倩.角膜胶原交联联合准分子激光原位角膜磨镶术(LASIK)矫正屈光不正的临床观察.眼科新进展 2017;37(10):970-972
2王瑞娜,郭红亮,马挺,等.有晶状体后房型人工晶状体植入术与飞秒激光LASIK术后视觉质量的比较.中华实验眼科杂志 2017;35(9):833-837
3周跃华.要重视准分子激光角膜屈光手术围手术期的用药规范.中华实验眼科杂志 2016;34(5):385-388
4郑燕,周跃华,张晶,等.准分子激光原位角膜磨镶术联合快速角膜交联术矫正薄角膜近视合并散光的早期疗效.中华实验眼科杂志 2016;34(5):460-465
5成琼,廉井财,张静,等.采用不同切削中心的准分子激光原位角膜磨镶术治疗近视眼的效果对比分析.中华眼科杂志 2016;52(7):499-506
6王杰,杜之渝,李雪瑶,等.LASIK术后眼前节形态变化及相关影响因素分析.中华实验眼科杂志 2016;34(8):729-733
7宋学英,李岳美,李庆和,等.SMILE及LASEK治疗近视散光的临床对比研究.眼科新进展 2016;36(10):970-972
8华焱军,王勤美,黄锦海,等.GalileiⅡ双通道Scheimpflug眼前房分析系统测定LASIK术后角膜屈光力的可重复性评价.中华实验眼科杂志 2016;34(4):357-362
9赵伟,王雁,李华,等.不同程度近视和散光患者行飞秒激光小切口角膜基质透镜取出术的早期临床疗效评估.中华实验眼科杂志 2017;35(4):349-354
10 Tabacaru B,Stanca HT.One year refractive outcomes of Femtosecond-LASIK in mild,moderate and high myopia.Rom J Ophthalmol 2017;61(1):23-31
11 Reinstein DZ,Carp GI,Archer TJ,et al.Long-term Visual and Refractive Outcomes After LASIK for High Myopia and Astigmatism From -8.00 to -14.25D.J Refract Surg 2016;32(5):290-297
12 Avetisov SE,Mamikonyan VR,Shmelevademir OA,et al.Intraocular pressure,ocular blood flow,and corneal biomechanics changes after LASIK surgery for myopia.Vestn Oftalmol 2016;132(4):24-28
13 Hashemi H,Ghaffari R,Miraftab M,et al.Femtosecond laser-assisted LASIK versus PRK for high myopia:comparison of 18-month visual acuity and quality.Int Ophthalmol 2017;37(4):995-1001
14 Zhang Y,Shen Q,Jia Y,et al.Clinical Outcomes of SMILE and FS-LASIK Used to Treat Myopia:A Meta-analysis.J Refract Surg 2016;32(4):256-265
15 Ahmedbegovi A,Gri?evi.Efficacy and safety of iris-supported phakic lenses(Verisyse) for treating moderately high myopia.Med Glas(Zenica) 2016;13(1):25-30
16 Wang X,Zhao G,Lin J,et al.Efficacy and Safety of Topical Timolol Eye Drops in the Treatment of Myopic Regression after Laser In Situ Keratomileusis:A Systematic Review and Meta-Analysis.J Ophthalmol 2015;2015:985071
17 Ikeda T,Shimizu K,Igarashi A,et al.Twelve-Year Follow-Up of Laser In Situ Keratomileusis for Moderate to High Myopia.Biomed Res Int 2017;2017:9391436
18 Denoyer A,Landman E,Trinh L,et al.Dry eye disease after refractive surgery:comparative outcomes of small incision lenticule extraction versus LASIK.Ophthalmology 2015;122(4):669-676
19 Liu M,Chen Y,Wang D,et al.Clinical Outcomes After SMILE and Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism:A Prospective Randomized Comparative Study.Cornea 2015;35(2):210-216
2王瑞娜,郭红亮,马挺,等.有晶状体后房型人工晶状体植入术与飞秒激光LASIK术后视觉质量的比较.中华实验眼科杂志 2017;35(9):833-837
3周跃华.要重视准分子激光角膜屈光手术围手术期的用药规范.中华实验眼科杂志 2016;34(5):385-388
4郑燕,周跃华,张晶,等.准分子激光原位角膜磨镶术联合快速角膜交联术矫正薄角膜近视合并散光的早期疗效.中华实验眼科杂志 2016;34(5):460-465
5成琼,廉井财,张静,等.采用不同切削中心的准分子激光原位角膜磨镶术治疗近视眼的效果对比分析.中华眼科杂志 2016;52(7):499-506
6王杰,杜之渝,李雪瑶,等.LASIK术后眼前节形态变化及相关影响因素分析.中华实验眼科杂志 2016;34(8):729-733
7宋学英,李岳美,李庆和,等.SMILE及LASEK治疗近视散光的临床对比研究.眼科新进展 2016;36(10):970-972
8华焱军,王勤美,黄锦海,等.GalileiⅡ双通道Scheimpflug眼前房分析系统测定LASIK术后角膜屈光力的可重复性评价.中华实验眼科杂志 2016;34(4):357-362
9赵伟,王雁,李华,等.不同程度近视和散光患者行飞秒激光小切口角膜基质透镜取出术的早期临床疗效评估.中华实验眼科杂志 2017;35(4):349-354
10 Tabacaru B,Stanca HT.One year refractive outcomes of Femtosecond-LASIK in mild,moderate and high myopia.Rom J Ophthalmol 2017;61(1):23-31
11 Reinstein DZ,Carp GI,Archer TJ,et al.Long-term Visual and Refractive Outcomes After LASIK for High Myopia and Astigmatism From -8.00 to -14.25D.J Refract Surg 2016;32(5):290-297
12 Avetisov SE,Mamikonyan VR,Shmelevademir OA,et al.Intraocular pressure,ocular blood flow,and corneal biomechanics changes after LASIK surgery for myopia.Vestn Oftalmol 2016;132(4):24-28
13 Hashemi H,Ghaffari R,Miraftab M,et al.Femtosecond laser-assisted LASIK versus PRK for high myopia:comparison of 18-month visual acuity and quality.Int Ophthalmol 2017;37(4):995-1001
14 Zhang Y,Shen Q,Jia Y,et al.Clinical Outcomes of SMILE and FS-LASIK Used to Treat Myopia:A Meta-analysis.J Refract Surg 2016;32(4):256-265
15 Ahmedbegovi A,Gri?evi.Efficacy and safety of iris-supported phakic lenses(Verisyse) for treating moderately high myopia.Med Glas(Zenica) 2016;13(1):25-30
16 Wang X,Zhao G,Lin J,et al.Efficacy and Safety of Topical Timolol Eye Drops in the Treatment of Myopic Regression after Laser In Situ Keratomileusis:A Systematic Review and Meta-Analysis.J Ophthalmol 2015;2015:985071
17 Ikeda T,Shimizu K,Igarashi A,et al.Twelve-Year Follow-Up of Laser In Situ Keratomileusis for Moderate to High Myopia.Biomed Res Int 2017;2017:9391436
18 Denoyer A,Landman E,Trinh L,et al.Dry eye disease after refractive surgery:comparative outcomes of small incision lenticule extraction versus LASIK.Ophthalmology 2015;122(4):669-676
19 Liu M,Chen Y,Wang D,et al.Clinical Outcomes After SMILE and Femtosecond Laser-Assisted LASIK for Myopia and Myopic Astigmatism:A Prospective Randomized Comparative Study.Cornea 2015;35(2):210-216