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聚乙二醇400/丙二醇/羟丙基瓜尔胶与0.1%透明质酸钠对白内障摘除术后不适的影响:一项比较研究。

Impact of polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate on postoperative discomfort following cataract extraction surgery: a comparative study.

作者信息

Labiris Georgios, Ntonti Panagiota, Sideroudi Haris, Kozobolis Vassilios

机构信息

Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece.

Eye Institute of Thrace, Alexandroupolis, Greece.

出版信息

Eye Vis (Lond). 2017 May 10;4:13. doi: 10.1186/s40662-017-0079-5. eCollection 2017.

Abstract

BACKGROUND

Universal postoperative guidelines for cataract extraction surgery are yet to be introduced. Artificial tears are gaining popularity as an additional integral component of the postoperative regime. The primary objective of this study was to explore the impact of two prevalent artificial tear preparations on postoperative discomfort following cataract extraction surgery.

METHODS

A total of 180 patients that underwent cataract extraction surgery were randomly divided into three groups according to their postoperative regime: a) Study group 1 (SG1) received a fixed combination of tobramycin and dexamethasone (FCTD) quid for 3 weeks and, additionally polyethylene glycol 400/propylene glycol/hydroxypropyl-guar quid, for 6 weeks, b) Study group 2 (SG2) received FCTD quid for 3 weeks and, additionally 0.1% sodium hyaluronate provided in the COMOD® device quid, for 6 weeks, and, c) Control Group (CG) received only FCTD quid for 3 weeks. The following indexes were evaluated at three postoperative checkpoints: 1) Subjective discomfort index (SDI) derived from four direct 10-scale Likert-type questions that were addressed to the patient and pertained to: a) foreign body sensation (FBS), b) blinking discomfort (BD), c) stinging sensation (SS), d) tearing sensation (TS), 2) Tear break-up time (TBUT), 3) Central corneal thickness (CCT) and, 4) Central Corneal Sensitivity (CCS).

RESULTS

Both groups showed increased CCT values at the first examination point and reduced CCS values at all examination points. Furthermore, both SGs had better TBUT times at all examination points compared to CG (CG: 8.86 ± 1.08, SG1: 9.59 ± 1.45, CG2: 9.45 ± 1.33,  < 0.05). BD was significantly better in both SGs only at the 1 week of examination, while SDI values were better until the 3 week and only borderline better at 6 week. Lastly, no significant differences were detected between SGs, regarding all parameters, at all examination points.

CONCLUSION

Polyethylene glycol 400/propylene glycol/hydroxypropyl-guar and 0.1% sodium hyaluronate provided in the COMOD® device seem to be equally efficient in alleviating OSD symptoms following cataract extraction surgery and any of them should be routinely added to the postoperative regime.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT02558218NCT02558218.

摘要

背景

白内障摘除手术的通用术后指南尚未出台。人工泪液作为术后护理的一个额外重要组成部分正日益受到欢迎。本研究的主要目的是探讨两种常见人工泪液制剂对白内障摘除手术后眼部不适的影响。

方法

总共180例接受白内障摘除手术的患者根据其术后护理方案被随机分为三组:a)研究组1(SG1)接受3周的妥布霉素和地塞米松固定组合(FCTD)滴眼液,另外接受6周的聚乙二醇400/丙二醇/羟丙基瓜尔胶滴眼液,b)研究组2(SG2)接受3周的FCTD滴眼液,另外接受6周的COMOD®装置提供的0.1%透明质酸钠滴眼液,c)对照组(CG)仅接受3周的FCTD滴眼液。在术后三个检查点评估以下指标:1)主观不适指数(SDI),由向患者提出的四个直接的10级李克特式问题得出,涉及:a)异物感(FBS),b)眨眼不适(BD),c)刺痛感(SS),d)流泪感(TS),2)泪膜破裂时间(TBUT),3)中央角膜厚度(CCT),4)中央角膜敏感度(CCS)。

结果

两组在第一个检查点时CCT值均升高,在所有检查点时CCS值均降低。此外,与CG组相比,两个研究组在所有检查点的TBUT时间均更好(CG组:8.86±1.08,SG1组:9.59±1.45,SG2组:9.45±1.33,P<0.05)。仅在检查的第1周,两个研究组的BD情况均明显更好,而SDI值在第3周之前更好,在第6周仅略好。最后,在所有检查点,两个研究组在所有参数方面均未检测到显著差异。

结论

COMOD®装置提供的聚乙二醇400/丙二醇/羟丙基瓜尔胶和0.1%透明质酸钠在减轻白内障摘除手术后的眼表疾病症状方面似乎同样有效,其中任何一种都应常规添加到术后护理方案中。

试验注册

ClinicalTrials.gov标识符:https://clinicaltrials.gov/ct2/show/NCT02558218NCT02558218

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fbb/5424421/930e9f939bba/40662_2017_79_Fig1_HTML.jpg

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