Tomilova E V, Nemsitsveridze M N, Panova I E
Saint Petersburg branch of S. Fyodorov Eye Microsurgery Federal State Institution, 21 Yaroslava Gasheka St., Saint Petersburg, Russia, 192283.
Vestn Oftalmol. 2017;133(3):44-50. doi: 10.17116/oftalma2017133344-50.
to compare the dynamics of epithelial wound healing under two different post-op treatments in patients after uncomplicated phacoemulsification.
This prospective randomized clinical trial included 40 eyes of 40 patients aged 66.4±8.2 years who underwent uncomplicated phacoemulsification with flexible intraocular lens implantation through a 2.2-mm corneal incision. Patients were randomized to receive either dexamethasone 0.1% and diclofenac 0.1% (n=20 eyes, Group I), or bromfenac 0.09% (n=20 eyes, Group II). Also, all patients instilled levofloxacin 0.5%. The dynamics of epithelial wound healing was assessed with the RTVue-100 spectral domain optical coherence tomograph with CAM-L corneal module in the 3D CORNEA mode 2 hours after surgery and on days 1, 3, 5, and 10.
The postoperative period was uneventful in all cases. Two hours after surgery, epithelial defects were found in all eyes and their length did not differ statistically p=0.47. On the first day after surgery, complete epithelization was observed in 30% of cases from Group I and 60% of cases from Group II. The average length of epithelial defects was reliably smaller in Group II than in Group I (p=0.04 respectively). On postoperative day 3, 20% eyes from Group I still had epithelial defects with the average length of 0.45±0.13 mm, while there was only one eye with a 0.2-mm epithelial defect in Group II. Finally, on postoperative day 5, there was a single 0.3-mm epithelial defect in one eye from Group I. On day 10, none of the patients had epithelial defects in either group.
Epithelial wound healing at the site of corneal incision after non-complicated phacoemulsification was found to be faster in patients instilled with bromfenac twice daily than in patients receiving dexamethasone and diclofenac four times daily as anti-inflammatory therapy and given topical fluoroquinolones for antibacterial purpose.
比较单纯白内障超声乳化术后两种不同术后治疗方式下上皮伤口愈合的动态变化。
本前瞻性随机临床试验纳入了40例年龄为66.4±8.2岁患者的40只眼,这些患者均通过2.2毫米角膜切口接受了单纯超声乳化联合可折叠人工晶状体植入术。患者被随机分为接受0.1%地塞米松和0.1%双氯芬酸组(20只眼,第一组)或0.09%溴芬酸组(20只眼,第二组)。此外,所有患者均滴注0.5%左氧氟沙星。术后2小时以及术后第1、3、5和10天,使用配备CAM-L角膜模块的RTVue - 100光谱域光学相干断层扫描仪在3D CORNEA模式下评估上皮伤口愈合的动态变化。
所有病例术后过程均顺利。术后2小时,所有眼中均发现上皮缺损,其长度在统计学上无差异(p = 0.47)。术后第一天,第一组30%的病例和第二组60%的病例观察到完全上皮化。第二组上皮缺损的平均长度明显小于第一组(分别为p = 0.04)。术后第3天,第一组20%的眼仍有上皮缺损,平均长度为0.45±0.13毫米,而第二组只有一只眼有0.2毫米的上皮缺损。最后,术后第5天,第一组有一只眼有一个0.3毫米的上皮缺损。在第10天,两组患者均无上皮缺损。
发现每日滴注两次溴芬酸的患者在单纯白内障超声乳化术后角膜切口部位的上皮伤口愈合比每日接受四次地塞米松和双氯芬酸作为抗炎治疗并给予局部氟喹诺酮类药物用于抗菌目的的患者更快。