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新型交联眼部绷带凝胶改善准分子激光角膜切削术后上皮愈合:一项随机、盲法前瞻性研究。

Novel Cross-Linked Ocular Bandage Gel Improves Reepithelialization After Photorefractive Keratectomy: A Randomized, Masked Prospective Study.

机构信息

The Eye Institute of Utah, Salt Lake City, Utah, USA.

Slade & Baker Vision Center, Houston, Texas, USA.

出版信息

J Ocul Pharmacol Ther. 2020 Oct;36(8):602-608. doi: 10.1089/jop.2019.0156. Epub 2020 Jul 17.

DOI:10.1089/jop.2019.0156
PMID:32701012
Abstract

To compare, in a masked manner, a novel cross-linked hyaluronic acid ocular bandage gel (OBG) versus standard-of-care bandage contact lens (BCL) plus artificial tears with respect to safety and effectiveness in healing epithelial defects created for photorefractive keratectomy (PRK). This was a randomized, reading center-masked, exploratory study. Forty-five patients (myopic without significant anisometropia) scheduled for bilateral PRK (9-mm epithelial defect) were randomized post-PRK to treatment with OBG 8 times daily for 3 days, followed by 4 times daily for 11 days (Group 1); OBG 4 times daily for 14 days (Group 2); or BCL and artificial tears (Control). A masked reading center used image analysis of digital slit lamp photos of the fluorescein-stained cornea to evaluate defect size during the 14-day postoperative follow-up period. Effectiveness endpoints were (1) time to complete closure of the corneal defect and (2) proportion of patients with complete healing on day 3 postoperatively, whose defect remained closed. Safety assessments included findings for adverse events and vision, Standard Patient Evaluation of Eye Dryness (SPEED) Questionnaire, slit lamp, intraocular pressure, and fundus examinations. The proportion of patients with complete healing at 3 days was 73.3%, 86.7%, and 66.7% of patients in Groups 1, 2, and Control, respectively. On day 2, the mean wound size was 6%-26% smaller in Groups 1 and 2 compared with Control. No safety concern arose. SPEED scores were not significantly different across groups. OBG offers a well-tolerated and effective therapy for quickly reepithelializing the cornea following trauma, disease, or surgery.

摘要

为了比较一种新型交联透明质酸眼绷带凝胶(OBG)与标准护理绷带接触镜(BCL)加人工泪液在治疗光折射性角膜切削术(PRK)引起的上皮缺损方面的安全性和有效性,我们采用了一种随机、有掩蔽、探索性的研究方法。45 名(近视但无明显屈光参差)拟行双侧 PRK(上皮缺损 9mm)的患者在 PRK 后随机分为三组:每日 8 次使用 OBG 治疗 3 天,然后每日 4 次治疗 11 天(第 1 组);每日 4 次使用 OBG 治疗 14 天(第 2 组);或 BCL 和人工泪液(对照组)。一个有掩蔽的阅读中心使用数字裂隙灯照片分析评估了在术后 14 天的随访期间荧光素染色角膜的缺损大小。有效性终点包括:(1)角膜缺损完全闭合的时间;(2)术后第 3 天完全愈合且其缺损保持闭合的患者比例。安全性评估包括不良事件和视力、标准患者眼干燥评估(SPEED)问卷、裂隙灯、眼压和眼底检查的结果。第 1、2 组和对照组在第 3 天完全愈合的患者比例分别为 73.3%、86.7%和 66.7%。第 2 天,第 1、2 组的平均伤口大小比对照组小 6%-26%。没有出现安全性问题。各组间 SPEED 评分无显著差异。OBG 为创伤、疾病或手术后角膜快速再上皮化提供了一种耐受良好且有效的治疗方法。

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