Minamiaoyama Eye Clinic, Tokyo, Japan.
Minamiaoyama Eye Clinic, Tokyo, Japan.
Am J Ophthalmol. 2014 Mar;157(3):616-22.e1. doi: 10.1016/j.ajo.2013.11.017. Epub 2013 Nov 27.
To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK).
Prospective randomized comparative trial.
A total of 206 eyes of 105 patients who underwent LASIK were enrolled in this study. Patients were randomly assigned to 1 of 4 treatment groups according to the postoperative treatment: artificial tears, sodium hyaluronate, diquafosol tetrasodium, and a combination of hyaluronate and diquafosol. Questionnaire responses reflecting subjective dry eye symptoms, uncorrected and corrected visual acuity, functional visual acuity, manifest refraction, tear break-up time, fluorescein corneal staining, Schirmer test, and corneal sensitivity were examined before and 1 week and 1 month after LASIK.
Distance uncorrected visual acuity was significantly better in the combination group than in the hyaluronate group 1 week and 1 month after LASIK. Near uncorrected visual acuity was significantly better in the combination group than in the artificial tear and diquafosol groups 1 week and 1 month after LASIK. Distance functional visual acuity improved significantly only in the combination group 1 month after LASIK. The Schirmer value in the combination group was significantly higher than that in the hyaluronate group at 1 month after LASIK. Subjective dry eye symptoms in the combination group improved significantly compared with those in the other groups 1 week after surgery.
Our results suggest that hyaluronate and diquafosol combination therapy is beneficial for early stabilization of visual performance and improvement of subjective dry eye symptoms in patients after LASIK.
评估二氢沙奎那林四钠盐和透明质酸钠联合治疗 LASIK 术后干眼症的可能优势。
前瞻性随机对照试验。
共纳入 206 只眼 105 例接受 LASIK 手术的患者参与本研究。患者根据术后治疗随机分为 4 个治疗组：人工泪液、透明质酸钠、二氢沙奎那林四钠盐和透明质酸钠与二氢沙奎那林联合治疗。术前及 LASIK 术后 1 周和 1 个月检查反映主观干眼症状、未矫正和矫正视力、功能性视力、明视折射、泪膜破裂时间、荧光素角膜染色、泪液分泌试验和角膜敏感性的问卷调查结果。
LASIK 术后 1 周和 1 个月，联合组的远距未矫正视力明显优于透明质酸钠组。LASIK 术后 1 周和 1 个月，联合组的近距未矫正视力明显优于人工泪液组和二氢沙奎那林组。仅在联合组，术后 1 个月的远距功能性视力显著改善。联合组的 Schirmer 值在 LASIK 术后 1 个月时明显高于透明质酸钠组。与其他组相比，联合组的术后 1 周的主观干眼症状明显改善。
我们的结果表明，透明质酸钠和二氢沙奎那林联合治疗有利于 LASIK 术后患者早期稳定视力表现和改善主观干眼症状。
