Kamiya Kazutaka, Aizawa Daisuke, Igarashi Akihito, Komatsu Mari, Shimizu Kimiya
Department of Ophthalmology, University of Kitasato School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa, Japan.
Am J Ophthalmol. 2008 Feb;145(2):233-238. doi: 10.1016/j.ajo.2007.09.036. Epub 2007 Dec 11.
To assess effects of antiglaucoma drugs on refractive outcomes in eyes with myopic regression after laser in situ keratomileusis (LASIK).
Prospective, nonrandomized clinical trial.
We examined 27 eyes with mean myopic regression +/- standard deviation of -1.26 +/- 0.48 diopters (D; range, -0.50 to -2.25 D) after LASIK. Nipradilol 2.5% was administered topically twice daily to these regressive eyes. We obtained the refraction (spherical equivalent, astigmatism), intraocular pressure (IOP) measurements, pachymetry, geometry, and refractive power of the cornea before and three months after treatment.
Mean manifest refraction was improved significantly from -1.02 +/- 0.52 D to -0.44 +/- 0.39 D (P < .001). However, mean manifest astigmatism was changed from -0.55 +/- 0.30 D to -0.49 +/- 0.22 D, but the difference was not significant (P = .23). The IOP was decreased significantly from 11.4 +/- 2.4 mm Hg to 9.4 +/- 1.3 mm Hg (P < .001). Central corneal thickness was not changed significantly from 505.2 +/- 39.3 microm to 503.6 +/- 38.7 microm (P = .61). The posterior corneal surface was shifted posteriorly by 9.1 +/- 8.2 microm, and the total refractive power of the cornea was decreased significantly, by 0.63 +/- 0.62 D (P < .001), at three months after application.
The preliminary data show that antiglaucoma drugs are effective for the reduction of the refractive regression, especially of the spherical errors, after LASIK. It is suggested that backward movement of the cornea may occur, possibly flattening the corneal curvature by lowering the IOP. Reduction of the IOP may contribute to improving regression after keratorefractive surgery.
评估抗青光眼药物对激光原位角膜磨镶术(LASIK)后近视回退眼屈光结果的影响。
前瞻性、非随机临床试验。
我们检查了27只LASIK术后平均近视回退度数±标准差为-1.26±0.48屈光度(D;范围,-0.50至-2.25 D)的眼睛。对这些回退眼每天局部应用两次2.5%尼普地洛。我们在治疗前和治疗三个月后获得了屈光度(等效球镜度、散光)、眼压(IOP)测量值、角膜厚度测量、角膜形态和角膜屈光力。
平均显验光从-1.02±0.52 D显著改善至-0.44±0.39 D(P <.001)。然而,平均显散光从-0.55±0.30 D变为-0.49±0.22 D,但差异不显著(P =.23)。眼压从11.4±2.4 mmHg显著降低至9.4±1.3 mmHg(P <.001)。中央角膜厚度从505.2±39.3微米至503.6±38.7微米无显著变化(P =.61)。应用三个月后,角膜后表面向后移位9.1±8.2微米,角膜总屈光力显著降低0.63±0.62 D(P <.001)。
初步数据表明,抗青光眼药物对LASIK术后屈光回退,尤其是球镜误差的减少有效。提示可能会发生角膜后移,可能是通过降低眼压使角膜曲率变平。眼压降低可能有助于改善角膜屈光手术后的回退。