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含透明质酸钠和泛醇滴眼液治疗白内障手术后干眼对眼表改善的评估

Evaluation of Dry Eye Treatment with Sodium Hyaluronate- and Dexpanthenol-Containing Eye Drops on Ocular Surface Improvement after Cataract Surgery.

作者信息

Köppe Maximilian K, Hallak Mustafa K, Stengele Annette L, Khoramnia Ramin, Auffarth Gerd U

机构信息

International Vision Correction Research Centre (IVCRC), University Eye Clinic Heidelberg, 69120 Heidelberg, Germany.

出版信息

Diagnostics (Basel). 2024 May 25;14(11):1097. doi: 10.3390/diagnostics14111097.

Abstract

BACKGROUND

To clinically evaluate how dry eye symptoms in preoperatively diagnosed dry eye patients change with the use of sodium hyaluronate- and dexpanthenol-containing eye drops (HYLO CARE (HC), URSAPHARM Arzneimittel GmbH, Saarbruecken, Germany) after cataract surgery. The aim of the study was not to compare different eye drops but to implement standard treatment in patients with dry eye undergoing cataract surgery. The impact of treatment was evaluated using Symptom Assessment Tools for Dry Eye.

METHODS

In this prospective, single-center, open-label clinical trial, 49 patients undergoing cataract surgery were included who showed signs and symptoms of dry eye disease assessed by the Symptom Assessment in Dry Eye (Visual Analogue Scale (VAS)) questionnaire, Ocular Surface Disease Index (OSDI), and fluorescein tear break-up Time (TBUT). Patients were instructed to apply HC three to four times a day for 5 weeks in the operated eye in addition to the standard postoperative topical anti-inflammatory regimen. The primary endpoint was the change in TBUT. Secondary endpoints were the assessment of the subjective symptoms (VAS), corrected distance visual acuity (CDVA), and slit-lamp examination including the corneal staining score, Schirmer test, and intraocular pressure.

RESULTS

At 5 weeks after operation, the mean TBUT increased from 6.42 ± 1.57 s (s) to 7.81 ± 1.83 s in the per-protocol (PP) population ( > 0.001) and from 6.33 ± 1.64 s to 7.71 ± 2.05 s in the intention-to-treat (ITT) population ( < 0.001). There was a statistically significant decrease in all scores ( < 0.05) from the VAS questionnaire except for the tearing score ( = 0.062) at 5 weeks after operation. The mean total corneal staining score also decreased statistically significantly from 8.85 ± 2.49 before operation to 5.61 ± 3.37 at 5 weeks after operation on a 15-point scale.

CONCLUSIONS

Controlled standardized dry eye treatment (with HC) improved tear film stability, ocular surface defects, and subjective symptoms of dry eye disease in patients 5 weeks after undergoing cataract surgery. Both the patient and physician assessments indicated high efficacy, tolerability, and a reliable safety profile, as indicated by the low number of at least possibly related adverse events (AE), suggesting its beneficial role in the postoperative management of the ocular surface (OS) in patients with dry eye symptoms prior to and after cataract surgery.

摘要

背景

临床上评估术前诊断为干眼症的患者在白内障手术后使用含透明质酸钠和泛醇的眼药水(HYLO CARE(HC),德国萨尔布吕肯URSAPHARM制药有限公司)后干眼症状如何变化。本研究的目的不是比较不同的眼药水,而是对接受白内障手术的干眼症患者实施标准治疗。使用干眼症状评估工具评估治疗效果。

方法

在这项前瞻性、单中心、开放标签的临床试验中,纳入了49例接受白内障手术的患者,这些患者通过干眼症状评估(视觉模拟量表(VAS))问卷、眼表疾病指数(OSDI)和荧光素泪膜破裂时间(TBUT)评估显示出干眼疾病的体征和症状。除标准的术后局部抗炎方案外,指导患者在患眼每天使用HC三到四次,持续5周。主要终点是TBUT的变化。次要终点是主观症状(VAS)、矫正远视力(CDVA)的评估,以及裂隙灯检查,包括角膜染色评分、泪液分泌试验和眼压。

结果

术后5周,符合方案(PP)人群的平均TBUT从6.42±1.57秒(s)增加到7.81±1.83秒(P<0.001),意向性分析(ITT)人群从6.33±1.64秒增加到7.71±2.05秒(P<0.001)。术后5周,除流泪评分(P = 0.062)外,VAS问卷中的所有评分均有统计学显著下降(P<0.05)。在15分制下,平均总角膜染色评分也从术前的8.85±2.49显著下降到术后5周的5.61±3.37。

结论

对照标准化干眼治疗(使用HC)在白内障手术5周后的患者中改善了泪膜稳定性、眼表缺陷和干眼疾病的主观症状。患者和医生的评估均表明其具有高疗效、耐受性和可靠的安全性,至少可能相关的不良事件(AE)数量较低表明了这一点,提示其在白内障手术前后有干眼症状患者的眼表(OS)术后管理中具有有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d405/11171816/c057147ee295/diagnostics-14-01097-g001.jpg

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