Thanathanee Onsiri, Sriphon Phornrak, Anutarapongpan Orapin, Athikulwongse Raweewan, Thongphiew Prakairat, Rangsin Ram, Suwan-apichon Olan
1 Department of Ophthalmology, Faculty of Medicine, Srinagarind Hospital, Khon Kaen University , Khon Kaen, Thailand .
J Ocul Pharmacol Ther. 2015 Apr;31(3):165-8. doi: 10.1089/jop.2014.0107. Epub 2015 Jan 2.
To compare loteprednol etabonate 0.5%/tobramycin 0.3% (Zylet(®)) with dexamethasone 0.1%/tobramycin 0.3% (Tobradex(®)) in terms of the epithelial healing time, postoperative visual acuity, corneal haziness score, and intraocular pressure (IOP) in postoperative treatment after photorefractive keratectomy (PRK).
This prospective, randomized, double-masked (participants and assessors blinded) controlled study included 32 patients who underwent PRK. The patients were allocated equally into 2 groups by block randomization to receive either loteprednol etabonate (Lot) or dexamethasone (Dex) for 1 month after the surgery. The epithelial healing time, uncorrected visual acuity (UCVA), corneal haziness score, and IOP were evaluated at 1 week, 1 month, and 3 months.
The corneal epithelium was healed within 3 days in both groups; however, the epithelium was closed on the second day in 3 cases in the Lot group compared with 1 case in the Dex group. No significant differences were found for UCVA at 1 and 3 months (Fisher exact test, P>0.01). Similarly, there was no statistically significant difference in corneal haziness scores between the 2 groups at 1 and 3 months (Mann-Whitney U test, P>0.05). The number of patients experiencing significantly increased IOP (≥5 mmHg) from baseline at any visit for the Lot group (1/16 patients) was fewer than for the Dex group (3/16 patients).
Loteprednol etabonate was effective in postoperative PRK management and was significantly less likely to produce elevations in IOP than was dexamethasone.
比较0.5%氯替泼诺妥布霉素（卓比安（®））与0.1%地塞米松妥布霉素（托百士（®））在准分子激光屈光性角膜切削术（PRK）术后治疗中上皮愈合时间、术后视力、角膜混浊评分及眼压（IOP）方面的差异。
这项前瞻性、随机、双盲（参与者和评估者均不知情）对照研究纳入了32例行PRK的患者。通过区组随机化将患者平均分为2组，术后1个月分别接受氯替泼诺（Lot）或地塞米松（Dex）治疗。在术后1周、1个月和3个月评估上皮愈合时间、未矫正视力（UCVA）、角膜混浊评分和眼压。
两组角膜上皮均在3天内愈合；然而，Lot组有3例患者上皮在第二天闭合，而Dex组为1例。1个月和3个月时的UCVA无显著差异（Fisher精确检验，P>0.01）。同样，两组在1个月和3个月时角膜混浊评分也无统计学显著差异（Mann-Whitney U检验，P>0.05）。Lot组（1/16例患者）在任何一次随访中眼压从基线显著升高（≥5 mmHg）的患者数量少于Dex组（3/16例患者）。
氯替泼诺在PRK术后管理中有效，且与地塞米松相比，其导致眼压升高的可能性显著更低。
