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评价 0.01%次氯酸滴眼液联合常规治疗对真菌性角膜溃疡的管理效果:随机对照试验。

Evaluation of 0.01% Hypochlorous Acid Eye Drops Combined with Conventional Treatment in the Management of Fungal Corneal Ulcers: Randomized Controlled Trial.

机构信息

Department of Ophthalmology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China.

Xuzhou Medical University, Xuzhou, Jiangsu Province, China.

出版信息

Curr Eye Res. 2023 Oct;48(10):887-893. doi: 10.1080/02713683.2023.2226374. Epub 2023 Jul 26.

Abstract

PURPOSE

To evaluate the efficacy and safety of hypochlorous acid (HOCI) eye drops in the treatment of fungal keratitis.

METHODS

A total of 96 patients (96 eyes) with fungal keratitis were randomly divided into two groups: group Ι (conventional treatment + topical HOCI eye drops); The group II (conventional treatment). According to its severity, those patients were divided into grade Ι or grade II. Use of fungal scraping and culture to identify the type of fungal infection, slit lamp examination, and corneal fluorescein staining to observe regression, and confocal corneal microscopy to assess fungal mycelial changes. The main outcome measures were the success rate, healing time, visual recovery, and complications. The Kaplan-Meier curve method was used to analysis of the survival function of days to cure between the two groups.

RESULTS

There were no statistical differences between the two groups in terms of general condition, medical history, and grading. Corneal scraping results showed that all patients had filamentous fungi. For grade Ι patients, all patients were cured, and the patients in Group I showed faster healing speed than that in Group II ( = -3.665,  < .01). For grade II patients, the recovery time ( = -4.121,  < .01) and the disappearance of hypopyon ( = -4.291,  < .01) were significantly faster in the combination group. In grade Ι and II patients, the final visual acuity and the incidence of complications such as corneal neovascularization, cataract, and hyphema showed no differences in both groups. The survival curve showed that the healing rate of ulcers in the combination treatment group was faster than that in the conventional treatment group ( = 14.332,  = .001).

CONCLUSION

HOCI can accelerate the healing of fungal keratitis without obvious complications, indicating a promising future in the field of keratitis treatment.

摘要

目的

评估次氯酸(HOCI)滴眼液治疗真菌性角膜炎的疗效和安全性。

方法

将 96 例(96 眼)真菌性角膜炎患者随机分为两组:组 Ι(常规治疗+局部 HOCI 滴眼液);组 II(常规治疗)。根据其严重程度,将患者分为Ⅰ级或Ⅱ级。使用真菌刮片和培养来鉴定真菌感染的类型,通过裂隙灯检查和角膜荧光素染色观察其消退情况,并通过共聚焦角膜显微镜评估真菌菌丝的变化。主要观察指标为成功率、愈合时间、视力恢复和并发症。采用 Kaplan-Meier 曲线法分析两组患者治愈时间的生存函数。

结果

两组患者的一般情况、病史和分级均无统计学差异。角膜刮片结果显示所有患者均为丝状真菌。对于Ⅰ级患者,所有患者均治愈,且组 I 患者的愈合速度快于组 II( = -3.665,  < .01)。对于Ⅱ级患者,联合组的恢复时间( = -4.121,  < .01)和前房积脓消失时间( = -4.291,  < .01)均明显更快。在Ⅰ级和Ⅱ级患者中,两组患者的最终视力和角膜新生血管、白内障、前房积血等并发症的发生率均无差异。生存曲线显示联合治疗组溃疡愈合率快于常规治疗组( = 14.332,  = .001)。

结论

HOCI 可加速真菌性角膜炎的愈合,且无明显并发症,在角膜炎治疗领域具有广阔的应用前景。

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