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小切口微透镜提取术后强化超早期恢复的强化局部皮质类固醇方案。

Intensive topical steroid regimen for enhanced very early recovery after small incision lenticule extraction.

机构信息

Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, No.83 Fenyang Road, Shanghai, 200000, China.

Department of Refractive Surgery, Bright Eye Hospital, Fuzhou, 350000, China.

出版信息

Int Ophthalmol. 2023 Nov;43(11):4097-4103. doi: 10.1007/s10792-023-02827-7. Epub 2023 Aug 10.

Abstract

OBJECTIVE

This study aims to investigate the topical steroid regimen after small incision lenticule extraction (SMILE) for its effect on very early restoration of visual quality.

METHODS

A total of 180 patients (360 eyes) who underwent SMILE were enrolled. These patients were randomly assigned to three groups, with 60 patients in each group. The only difference among these three groups was the administration of 0.1% fluorometholone (FML) eye drops within two hours after SMILE: no FML in group A, 0.1% FML once every hour in group B and 0.1% FML once every half hour in group C. The corrected distance visual acuity (CDVA), objective scattering index (OSI), modulation transfer function (MTF) cut-off, Strehl ratio (SR) and incidence of subjective symptoms were evaluated preoperatively, at 2, 4 and 24 h and one week after SMILE.

RESULTS

The CDVA, MTF cut-off and SR values were significantly higher in group C, when compared to the other two groups, at 2 and 4 h after SMILE (p < 0.05). Furthermore, the OSI and incidence of subjective symptoms were significantly lower in group C, when compared to the other two groups, at 2 and 4 h after SMILE (p < 0.05). However, no significant differences in CDVA, MTF cut-off, SR, OSI and the incidence of subjective symptoms were detected among the three groups at 24 h and one week after SMILE (p > 0.05).

CONCLUSION

The administration of 0.1% FML eye drops every half hour within two hours after SMILE accelerates the restoration of visual and optical quality, and reduces the incidence of subjective symptoms during the very early phase after surgery.

摘要

目的

本研究旨在探讨小切口透镜切除术(SMILE)后局部皮质类固醇的方案对视觉质量早期恢复的影响。

方法

共纳入 180 例(360 眼)接受 SMILE 的患者。这些患者被随机分为三组,每组 60 例。三组唯一的区别是在 SMILE 后两小时内给予 0.1%氟米龙(FML)滴眼剂:A 组不给予 FML,B 组每小时给予 0.1%FML 一次,C 组每半小时给予 0.1%FML 一次。术前、SMILE 后 2、4 和 24 小时及 1 周时评估矫正远视力(CDVA)、客观散射指数(OSI)、调制传递函数(MTF)截止值、斯特列尔比(SR)和主观症状发生率。

结果

SMILE 后 2 和 4 小时,C 组的 CDVA、MTF 截止值和 SR 值均明显高于其他两组(p<0.05)。此外,SMILE 后 2 和 4 小时,C 组的 OSI 和主观症状发生率明显低于其他两组(p<0.05)。然而,SMILE 后 24 小时和 1 周时,三组间 CDVA、MTF 截止值、SR、OSI 和主观症状发生率无明显差异(p>0.05)。

结论

SMILE 后两小时内每半小时给予 0.1%FML 滴眼剂可加速视觉和光学质量的恢复,并降低术后早期主观症状的发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f655/10520117/6713855d0785/10792_2023_2827_Fig1_HTML.jpg

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