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新型治疗策略和创新润滑眼液在减少白内障手术相关干眼疾病中的应用:一项随机、前瞻性研究。

New Therapeutic Strategy and Innovative Lubricating Ophthalmic Solution in Minimizing Dry Eye Disease Associated with Cataract Surgery: A Randomized, Prospective Study.

机构信息

Eye Clinic, ASST Santi Paolo Carlo, San Paolo Hospital, Milan, Italy.

Department of Health Sciences, University of Milan, Milan, Italy.

出版信息

Adv Ther. 2020 Apr;37(4):1664-1674. doi: 10.1007/s12325-020-01288-z. Epub 2020 Mar 17.

Abstract

INTRODUCTION

To evaluate the effects of a new lubricating, antioxidant solution (VisuEvo) on dry eye disease (DED) in patients undergoing cataract surgery.

METHODS

Patients requiring cataract surgery with either healthy ocular surface or mild DED (tear break-up time, TBUT > 7, Schirmer I test > 15 mm/5 min) were enrolled in this multicenter, open-label, randomized, prospective study. Scheduled visits were 2 weeks before surgery (screening), day of surgery (V0), week 1 (V1), and 2 (V2) after surgery. VisuEvo was self-administered three times daily for the whole study duration (group A); the control group (group B) had no tear substitute administration. The primary endpoint was the change in TBUT over time; the secondary endpoints were changes in Ocular Surface Disease Index (OSDI), ocular surface staining, the Schirmer I test, and osmometry.

RESULTS

A total of 45 patients were included (group A, 23; group B, 22; age 74 ± 8 years). At the screening, TBUT was similar between the groups (group A, 8.5 ± 1.8 s; group B, 7.8 ± 0.7, p = 0.11). At the scheduled visits, TBUT increase vs screening visit was significantly higher in group A: +1.2 s at V0, +1.4 s at V1, and +1.9 s at V2 (p < 0.01). Also, OSDI was significantly lower in group A at V0, V1, and V2 (p < 0.027). After surgery, corneal staining was absent in 65-78% of group A compared with 54-59% in group B. The two groups did not show any significant differences of osmometry and the Schirmer I test.

CONCLUSIONS

The ocular surface was more protected and quickly restored from surgery when VisuEvo was used from 2 weeks preoperatively to 2 weeks postoperatively.

TRIAL REGISTRATION

ClinicalTrials.gov identifier, NCT03833908.

摘要

简介

评估一种新型润滑抗氧化溶液(VisuEvo)对白内障手术患者干眼(DED)的影响。

方法

本多中心、开放性、随机、前瞻性研究纳入了需要接受白内障手术且眼表健康或轻度 DED(泪膜破裂时间,TBUT > 7,Schirmer I 试验 > 15mm/5min)的患者。计划就诊时间为术前 2 周(筛查)、手术当天(V0)、术后第 1 周(V1)和第 2 周(V2)。在整个研究期间,VisuEvo 每天自我滴注 3 次(A 组);对照组(B 组)未给予人工泪液。主要终点为 TBUT 的随时间变化;次要终点为眼表疾病指数(OSDI)、眼表染色、Schirmer I 试验和渗透压的变化。

结果

共纳入 45 例患者(A 组 23 例,B 组 22 例;年龄 74±8 岁)。在筛查时,两组间 TBUT 相似(A 组 8.5±1.8s;B 组 7.8±0.7,p=0.11)。在计划就诊时,A 组与筛查时相比,TBUT 增加:V0 时增加 1.2s,V1 时增加 1.4s,V2 时增加 1.9s(p<0.01)。此外,A 组在 V0、V1 和 V2 时 OSDI 显著降低(p<0.027)。手术后,A 组 65-78%的患者角膜染色消失,而 B 组为 54-59%。两组间渗透压和 Schirmer I 试验无显著差异。

结论

与术前 2 周至术后 2 周使用 VisuEvo 相比,眼部表面从手术中得到更好的保护,且恢复更快。

试验注册

ClinicalTrials.gov 标识符,NCT03833908。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/955d/7140734/345af55589a0/12325_2020_1288_Fig1_HTML.jpg

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