Singh Aastha, Gour Abha, Dave Abhishek, Chouhan Lokesh, Buckshey Arjun, Mathur Umang
Department of Cornea and Refractive Surgery, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Department of Biostatistics, Dr. Shroff's Charity Eye Hospital, New Delhi, India.
Indian J Ophthalmol. 2020 Dec;68(12):2990-2994. doi: 10.4103/ijo.IJO_1503_20.
The aim of this study was to analyze the effect of timolol maleate (0.5%) eye drops in the treatment of myopic regression after laser-assisted in-situ keratomileusis (LASIK).
The study was conducted at a tertiary care eye hospital in north India between April 2017 & March 2018 as a prospective interventional study. Patients who underwent uneventful myopic LASIK with hansatome mechanical keratome and presented with regression were included in the study. Baseline demographic characteristics, time to presentation with regression best-corrected visual acuity (BCVA), refraction, intraocular pressure, central corneal thickness and keratometry were recorded at baseline and at each follow-up visit. The enrolled patients were prescribed timolol maleate (0.5%) eyedrops twice daily. They were followed up every month till 3 months on timolol maleate (0.5%) eyedrops and at 6 months post stopping the treatment.
Twenty-nine eyes of 15 patients were enrolled in the study. Mean pre LASIK spherical equivalent (SE) was - 7.48 ± 2.9 Diopters (Range-3.125 to -11.75 Diopters) and mean regression spherical equivalent was -1.02 ± 1.1 Diopters. There was a decrease in mean SE from presentation (intervention start point) up to 6 months follow-up (-1.34 ± 0.89 to -0.30 ± 0.29 Diopters). While posterior corneal curvature (K1 and K2 Back) changed significantly over treatment period (P = 0.0029, P = 0.0024 respectively), changes in anterior corneal curvature (K1 and K2 Front) were not significant (P = 0.05, P = 0.06 respectively). Central corneal thickness (CCT) and intraocular pressure (IOP) did not change significantly over treatment course.
Timolol maleate (0.5%) eyedrop is an effective modality for the treatment of refractive regression post LASIK circumventing the need for laser re-treatment in such patients. The most probable mechanism is reversal of the anterior bowing of the cornea in response to intraocular pressure changes.
本研究旨在分析0.5%马来酸噻吗洛尔滴眼液对激光原位角膜磨镶术（LASIK）后近视回退的治疗效果。
本研究于2017年4月至2018年3月在印度北部一家三级眼科专科医院进行，为前瞻性干预研究。纳入接受汉森刀机械角膜刀行近视LASIK手术且出现回退的患者。记录基线人口统计学特征、出现回退时的时间、最佳矫正视力（BCVA）、屈光、眼压、中央角膜厚度和角膜曲率，在基线和每次随访时进行记录。入选患者每天使用0.5%马来酸噻吗洛尔滴眼液两次。在使用0.5%马来酸噻吗洛尔滴眼液治疗期间每月随访一次，直至3个月，停药后6个月进行随访。
15例患者的29只眼纳入本研究。LASIK术前平均等效球镜度（SE）为-7.48±2.9屈光度（范围-3.125至-11.75屈光度），平均回退等效球镜度为-1.02±1.1屈光度。从出现回退（干预起始点）至6个月随访期间，平均SE有所下降（从-1.34±0.89降至-0.30±0.29屈光度）。虽然治疗期间后角膜曲率（K1和K2 Back）有显著变化（分别为P = 0.0029，P = 0.0024），但前角膜曲率（K1和K2 Front）的变化不显著（分别为P = 0.05，P = 0.06）。治疗过程中中央角膜厚度（CCT）和眼压（IOP）无显著变化。
0.5%马来酸噻吗洛尔滴眼液是治疗LASIK术后屈光回退的有效方法，可避免此类患者再次进行激光治疗。最可能的机制是角膜前突因眼压变化而逆转。
