同一受试者使用两种不同类型眼药水时泪液渗透压的变化。

Intrasubject tear osmolarity changes with two different types of eyedrops.

作者信息

Montani Giancarlo

机构信息

Course of Optics and Optometry, University of Salento, Salento, Italy.

出版信息

Optom Vis Sci. 2013 Apr;90(4):372-7. doi: 10.1097/OPX.0b013e318288bdbe.

DOI:10.1097/OPX.0b013e318288bdbe

PMID:23507972

Abstract

PURPOSE

To analyze tear osmolarity over time after instillation of two commercially available eyedrops.

METHODS

This prospective, nonrandomized, simultaneous, comparative, open-label, unmasked study included 40 eyes of 20 consecutive subjects (mean age, 34.8 ± 11.8 years) with a diagnosis of moderate dry eye. Subjects were instructed to administer contralaterally controlled lubricants to the right ([RE] Blink Intensive Tears, Abbott Medical Optics, Santa Ana, CA) and left ([LE] Optive Eye Drops, Allergan Inc., Irvine, CA) eyes three times daily for 21 days. The impact of hypoosmotic (RE) and osmoprotective (LE) drops on tear osmolarity (TearLab Osmolarity System, TearLab Corporation, San Diego, CA) was measured before and 30, 60, 90, 120, and 180 minutes after instillation of the first set of drops. Follow-up measurements were performed 22 days later, 1 day after the subjects stopped using the drops.

RESULTS

In RE, compared with baseline, tear osmolarity values were significantly reduced at all time points after instillation, including at 180 minutes (p < 0.01). In LE, osmolarity was significantly reduced from baseline at all time points through 120 minutes (p < 0.01) but returned toward baseline at 180 minutes (p < 0.11). The minimal value reached at 90 minutes after instillation or the average reduction from baseline osmolarity was 27.6 ± 9.5 mOsm/L for RE as compared with 22.1 ± 12.3 mOsm/L for LE. Both groups showed significantly lower tear osmolarity at 21 days compared with that at baseline (hypoosmotic, 307.8 ± 11.9 mOsm/L vs. 329.4 ± 8.4 mOsm/L, p < 0.001; osmoprotective, 316.1 ± 12.5 mOsm/L vs. 327.6 ± 8.4 mOsm/L, p < 0.002).

CONCLUSIONS

Our results showed that both eyedrops reduced tear osmolarity within a short time frame after drop instillation (i.e., up to 120 minutes) and after a longer time frame (i.e., 21 days of application). However, hypoosmotic drops with sodium hyaluronate reduce tear osmolarity at a greater and more sustained rate than glycerin and carboxymethylcellulose-based osmoprotectants.

摘要

目的

分析滴入两种市售眼药水后随时间变化的泪液渗透压。

方法

这项前瞻性、非随机、同步、对比、开放标签、非盲法研究纳入了20名连续受试者（平均年龄34.8±11.8岁）的40只眼睛，这些受试者被诊断为中度干眼症。受试者被指示每天三次向右眼（[RE]Blink Intensive Tears，雅培医疗光学公司，加利福尼亚州圣安娜）和左眼（[LE]Optive眼药水，爱尔康公司，加利福尼亚州欧文）对侧使用对照润滑剂，持续21天。在滴入第一组眼药水之前以及滴入后30、60、90、120和180分钟，使用泪液渗透压系统（TearLab公司，加利福尼亚州圣地亚哥）测量低渗（RE）和渗透压保护（LE）眼药水对泪液渗透压的影响。在受试者停止使用眼药水1天后，即22天后进行随访测量。

结果

在RE组，与基线相比，滴入后所有时间点的泪液渗透压值均显著降低，包括180分钟时（p<0.01）。在LE组，直至120分钟时，渗透压从基线开始显著降低（p<0.01），但在180分钟时恢复至接近基线水平（p<0.11）。RE组在滴入后90分钟达到的最小值或相对于基线渗透压的平均降低值为27.6±9.5mOsm/L，而LE组为22.1±12.3mOsm/L。与基线相比，两组在21天时的泪液渗透压均显著降低（低渗组，307.8±11.9mOsm/L对329.4±8.4mOsm/L，p<0.001；渗透压保护组，316.1±12.5mOsm/L对327.6±8.4mOsm/L，p<0.002）。