典必殊及普南扑灵对Flap-Free Epi-LASIK术后疼痛及泪膜的影响

发布时间：2018-03-10 16:16

  本文选题：Flap-free　切入点：Epi-LASIK　出处：《南华大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的:研究典必殊及普南扑灵(普拉洛芬滴眼液)对去瓣准分子激光上皮下角膜磨镶术(Flap-free epipolis laser in-situ keratomileusis, Flap-free Epi-LASIK)术后疼痛、早期视力恢复、角膜上皮愈合、泪膜及Haze的影响。 方法:选取2009年10月至2010年4月在本院行Flap-free Epi-LASIK手术患者120例240眼。随机分为试验1组(典必殊滴眼液组)、试验2组(普南扑灵和典必殊滴眼液组)和常规用药组(对照组),对3组病例术后第1d、3d、5d、7d、15d及第1m、2m、3m、4m、6m术后角膜刺激症状、裸眼视力、最佳矫正视力、角膜上皮愈合、眼压、泪膜破裂时间、泪液分泌试验、泪液蕨类试验、结膜印记细胞学检查、Haze进行对比观察,并行计算机图像分析及对实验结果进行统计学分析。 结果:1.角膜刺激症状:术后1d及3d试验2组和常规用药组之间角膜刺激症状差异有统计学意义(t值分别为4.31, 2.77,P0.01),术后1d及3d试验2组和试验1组之间角膜刺激症状差异有统计学意义(t值分别为2.56, 2.14, P0.05),而在术后第5d及第7d各组间差异无统计学意义(P0.05)。2.角膜上皮愈合:术后1d,试验1组、试验2组与常规用药组所有病例角膜表面均有一层新生上皮覆盖;术后3d,试验1组、试验2组与常规用药组所有病例角膜上皮逐层愈合。术后5d大部分基本愈合,7d大部分愈合,平均愈合时间各组间差异无统计学意义(P0.05)。3.视力:试验1组和常规用药组分别有68%(27例54眼)和70%患者(28例56眼)术后1d、3d视力检查不能配合。其余病例术后1d、3d视力恢复试验2组与试验1组和常规用药组比较,差异有统计学意义(t值分别为2.90,2.17;3.71, 2.49,P0.01);术后5d、1m、3m各组间比较差异无统计学意义(P0.05)。4.眼压:术前各组眼压各组间差异无统计学意义(P0.05);术后眼压均低于术前水平,与术前比较有统计学意义(P0.05),术后1m、4m、6m眼压各组间差异无统计学意义(P0.05)。5.泪膜破裂时间(BUT):术后7d,1m各组BUT与术前比较差异有统计学意义(P0.05),术后1m以后逐渐增加,术后6m各组与术前比较差异无统计学意义(P0.05),术后7d、1m、3m、6m各组间差异无统计学意义(P0.05)。6.泪液分泌试验I (SchirmerⅠ试验):术后7d,1m各组泪液分泌量较术前减少,与术前比较差异有统计学意义(P0.05), 1m以后泪液分泌量逐步恢复,术后6m各组与术前比较差异无统计学意义(P0.05),术后7d、1m、3m、6m各组间差异无统计学意义(P0.05)。7.泪液蕨类试验(MFT):术后1m、3m、4m、6m各组泪液羊齿状试验差异无统计学意义(P0.05)。术后1m、3m、4m各组与术前比较差异有统计学意义(P0.05)。术后6m各组与术前比较差异无统计学意义(P0.05)。8.结膜印记细胞学检查:术后1m、3m、4m、6m各组印记细胞学检查差异无统计学意义(P0.05);术后1m、3m、4m、6m各组与术前比较差异有统计学意义(P0.05)。9.Haze:术后10d至1m可见到Haze发生,术后1m达到高峰,术后6m左右逐渐减轻或消失,术后7d、1m、3m、6m各组间差异无统计学意义(P0.05)。 结论: 1.Flap-free Epi-LASIK术前术后联合应用典必殊和普南扑灵可明显减轻患者术后的疼痛,促进早期视力恢复。 2.Flap-free Epi-LASIK术前术后联合应用典必殊和普南扑灵对角膜上皮愈合、眼压、Haze无明显影响。 3.Flap-free Epi-LASIK术后早期各组泪膜稳定性下降、泪液蕨类试验蕨样级别及结膜鳞状化生级别增高;泪膜稳定性、泪液分泌量、泪液蕨类试验、结膜印记细胞学检查在术后6个月时基本恢复到术前水平,提示早期联合应用典必殊和普南扑灵是安全有效的。
[Abstract]:Objective: To study the effect of TobraDex and pranopulin (Pranoprofen Eye Drops) to flap excimer laser epithelial keratomileusis (Flap-free Epipolis laser in-situ keratomileusis, Flap-free Epi-LASIK) postoperative pain, early recovery of visual acuity, corneal epithelial healing, effect of tear film and Haze.
Methods: from October 2009 to April 2010 in our hospital were performed Flap-free Epi-LASIK surgery in 120 eyes of 240 patients were randomly divided into experimental group 1 (TobraDex group), group 2 (pranopulin and TobraDex group) and conventional treatment group (control group), 3 cases of after the 1D, 3D, 5D, 7d, 15d and 1m, 2m, 3M, 4m, 6m postoperative corneal irritation, uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal epithelial healing, tear break-up time, Schirmer test, tear fern test, conjunctival impression cytology, Haze were observed and compared. Parallel computer image analysis and statistical analysis of experimental results.
Results: 1. corneal irritation: between 1D and 3D after 2 test group and conventional medication group corneal irritation symptoms was statistically significant (t = 4.31, 2.77, P0.01), 1D and 3D test in 2 groups after operation and test between the 1 groups of corneal irritation was statistically significant (t = 2.56, 2.14, P0.05), and no significant difference in postoperative 5D and 7d difference between the groups (P0.05):.2. corneal epithelial healing after 1D, the test group 1, test group 2 and control group all cases of corneal surface have a layer of the epithelium covering; 3D after the operation, the test group 1, test the 2 group and the control group in all cases of corneal epithelial healing layer 5D postoperatively. The most basic healing, 7d most healing, the average healing time difference between groups was not statistically significant (P0.05).3. vision: experiment group 1 and control group were 68% (27 cases, 54 eyes) and 70% patients (28 eyes of 56 cases after 1D, 3D) 鍔涙��鏌ヤ笉鑳介厤鍚，

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