Schulze Stephan D, Sekundo Walter, Kroll Peter
Department of Ophthalmology, University Hospital Giessen, Giessen, and Marburg, Location Marburg, Philipps University Marburg, Marburg, Germany.
Am J Ophthalmol. 2006 Aug;142(2):207-11. doi: 10.1016/j.ajo.2006.04.017.
To compare the effect of autologous serum versus hyaluronic acid for the treatment of epithelial corneal lesions in patients such as diabetics with reduced wound healing.
Prospective, randomized, masked clinical trial.
Diabetic patients undergoing pars plana vitrectomy mostly combined with cataract extraction and intraocular lens (IOL) implantation who received corneal abrasion for better intraoperative visualization were included in this study. A standardized 8-mm diameter corneal abrasion was performed. Patients were randomized into one group treated with hourly application of autologous serum and another treated with hyaluronic acid drops (Vislube). Besides the time necessary for closure of the corneal epithelium other parameters such as patients' age, gender, duration of surgery, history of diabetes, and current HbA1C were evaluated.
A total of 23 patients were enrolled (15 men, eight women); the autologous serum group consisted of 13 patients, the hyaluronic acid (Vislube) group consisted of 10 patients. Patients' mean age was 64.8 years; mean duration of diabetes was 19.4 years. On average, the operation lasted 145 minutes. Mean epithelialization time was 7.1 days in the hyaluronic acid group. In the autologous serum group, epithelium healed after a mean of 4.3 days. Mann-Whitney U test for statistical analysis showed a significant difference of epithelial closure time between both groups (P < .05); therefore, the study was stopped after treatment of 23 patients.
It appears that autologous serum leads to a much faster closure of corneal epithelial wounds after abrasion compared with artificial tears.
比较自体血清与透明质酸治疗伤口愈合能力降低的患者（如糖尿病患者）角膜上皮病变的效果。
前瞻性、随机、盲法临床试验。
纳入接受平坦部玻璃体切除术（大多联合白内障摘除及人工晶状体植入）且为了术中获得更好视野而进行角膜擦伤的糖尿病患者。进行标准化的直径8mm的角膜擦伤。患者被随机分为两组，一组每小时应用自体血清治疗，另一组应用透明质酸钠滴眼液（维速达尔）治疗。除角膜上皮闭合所需时间外，还评估了患者的年龄、性别、手术时长、糖尿病病史及当前糖化血红蛋白水平等其他参数。
共纳入23例患者（15例男性，8例女性）；自体血清组13例患者，透明质酸（维速达尔）组10例患者。患者平均年龄64.8岁；平均糖尿病病程19.4年。手术平均持续145分钟。透明质酸组平均上皮化时间为7.1天。自体血清组上皮平均在4.3天后愈合。采用曼-惠特尼U检验进行统计学分析，两组间上皮闭合时间有显著差异（P < 0.05）；因此，在治疗23例患者后研究终止。
与人工泪液相比，自体血清似乎能使角膜擦伤后上皮伤口的闭合速度更快。
