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比较第四代氟喹诺酮类药物对光折射性角膜切削术后上皮愈合的影响。

Comparison of the effects of fourth-generation fluoroquinolones on epithelial healing after photorefractive keratectomy.

机构信息

Department of Ophthalmology, Kang Dong Sacred Heart Hospital, Hallym University, Seoul, South Korea.

出版信息

Cornea. 2010 Nov;29(11):1236-40. doi: 10.1097/ICO.0b013e3181d5d955.

Abstract

PURPOSE

To compare the effects of fluoroquinolones gatifloxacin and moxifloxacin used for antimicrobial prophylaxis after photorefractive keratectomy (PRK) on epithelial healing.

METHODS

Forty-four patients randomly received the prophylactic antibiotics gatifloxacin (Gatiflo; 0.3% gatifloxacin ophthalmic solution, Handok, Chungbuk, Korea, no preservative) in 1 eye and moxifloxacin (Vigamox; 0.5% moxifloxacin hydrochloride ophthalmic solution, Alcon Laboratories, Inc, Fort Worth, TX, no preservative) in the fellow eye after PRK. Corneal epithelium was circumferentially removed along a 7-mm zone mark. After PRK, all patients used topical antibiotics 4 times a day until the epithelium healed completely. Starting from postoperative day 1, epithelial healing times and defect sizes were recorded by slit-lamp examination and anterior segment photography. Postoperative pain and discomfort induced by the eyedrops were recorded. Additionally, therapeutic contact lenses were cultured to assess the antibacterial efficacy of fluoroquinolones.

RESULTS

The mean epithelial healing times after PRK were similar for the 2 groups: 2.97 ± 0.41 days for gatifloxacin and 2.95 ± 0.48 days for moxifloxacin (P = 0.81). There was no statistically significant difference in mean defect size on each postoperative day between the treatment groups. There was no difference in postoperative pain and discomfort. No statistically significant differences were observed between eyes treated with gatifloxacin and moxifloxacin in terms of uncorrected visual acuity or best-corrected visual acuity at 3 months postoperatively.

CONCLUSION

No significant differences were found in the effects of the preservative-free fourth-generation fluoroquinolones gatifloxacin and moxifloxacin on epithelial healing after PRK.

摘要

目的

比较在准分子激光角膜切削术(PRK)后使用氟喹诺酮类抗生素加替沙星和莫西沙星进行抗菌预防对上皮愈合的影响。

方法

44 例患者随机接受预防性抗生素加替沙星(Gatiflo;0.3%加替沙星滴眼液,韩国忠北 Handok,无防腐剂)滴眼 1 眼,莫西沙星(Vigamox;0.5%盐酸莫西沙星滴眼液,美国艾尔康实验室公司,无防腐剂)滴眼于对侧眼。沿 7mm 区标记切除角膜上皮。PRK 后,所有患者均使用局部抗生素,每天 4 次,直至上皮完全愈合。术后第 1 天开始,通过裂隙灯检查和眼前段摄影记录上皮愈合时间和缺损大小。记录滴眼引起的术后疼痛和不适。此外,培养治疗性隐形眼镜以评估氟喹诺酮类药物的抗菌效果。

结果

两组 PRK 后平均上皮愈合时间相似:加替沙星组为 2.97±0.41 天,莫西沙星组为 2.95±0.48 天(P=0.81)。两组在术后每天的平均缺损大小上无统计学差异。术后疼痛和不适无差异。术后 3 个月,未矫正视力和最佳矫正视力方面,加替沙星眼和莫西沙星眼之间无差异。

结论

在 PRK 后,无防腐剂的第四代氟喹诺酮类抗生素加替沙星和莫西沙星对上皮愈合的影响无显著差异。

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