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飞秒激光辅助准分子激光原位角膜磨镶术后不同效价糖皮质激素治疗对泪液炎症因子和角膜光学密度的影响。

The effect of different potency glucocorticosteroids treatments on tear inflammatory factors and corneal optical density after femtosecond-assisted laser in situ keratomileusis.

机构信息

Department of Ophthalmology, Zigong First People's Hospital, Zigong, Sichuan, China.

Department of Internal Medicine, Zigong First People's Hospital, Zigong, Sichuan, China.

出版信息

Medicine (Baltimore). 2024 Sep 13;103(37):e39667. doi: 10.1097/MD.0000000000039667.

DOI:10.1097/MD.0000000000039667
PMID:39287273
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404958/
Abstract

To assess the impact of glucocorticosteroids with varying potencies on inflammatory mediators in tears and corneal optical density after femtosecond-assisted laser in situ keratomileusis (FS-LASIK). In a prospective study, 110 patients (220 eyes) who underwent FS-LASIK were divided into 2 groups: 55 patients (110 eyes) received dexamethasone, and another 55 patients (110 eyes) received fluorometholone. Visual acuity, intraocular pressure, and corneal optical density were measured before, 1 week, and 1 month after surgery. Tear fluid samples were also collected to assess expression levels of TNF-α, IL-1α, IL-6, and TGF-β1. One week after the procedure, the dexamethasone group exhibited elevated intraocular pressure (IOP) levels (P > .05) and a decreased expression of TNF-α in tears (P < .001) compared to the fluorometholone group. Within the 0 to 2 mm range from the corneal apex, the anterior corneal layer's optical density in the fluorometholone group surpassed that of the dexamethasone group (P < .05). At 1 month post-surgery, the IOP in the fluorometholone group was higher than that in the dexamethasone group (P < .05). In both the 0 to 2 mm and 2 to 6 mm intervals from the corneal apex, the optical density of the anterior corneal layer was significantly higher in the fluorometholone group compared to the dexamethasone group (P < .05). There was no statistically significant difference in visual acuity between the 2 groups at any postoperative time point. Short-term use of potent corticosteroids after FS-LASIK can swiftly address ocular surface inflammation, enhance corneal wound healing, reduce corneal edema, and accelerate the restoration of corneal transparency, in contrast to prolonged use of milder corticosteroids post-surgery.

摘要

评估不同效能糖皮质激素对飞秒激光辅助原位角膜磨镶术(FS-LASIK)后泪液中炎症介质和角膜光学密度的影响。前瞻性研究中,将 110 例(220 眼)行 FS-LASIK 的患者分为两组:55 例(110 眼)患者给予地塞米松,55 例(110 眼)患者给予氟米龙。术前、术后 1 周和 1 月测量视力、眼压和角膜光学密度,采集泪液标本评估 TNF-α、IL-1α、IL-6 和 TGF-β1 的表达水平。术后 1 周,地塞米松组眼压升高(P>0.05),泪液 TNF-α表达降低(P<0.001),与氟米龙组比较。角膜顶点 02mm 范围内,氟米龙组前角膜层光学密度高于地塞米松组(P<0.05)。术后 1 月,氟米龙组眼压高于地塞米松组(P<0.05)。角膜顶点 02mm 和 2~6mm 范围内,氟米龙组前角膜层光学密度均高于地塞米松组(P<0.05)。两组患者术后任何时间点视力均无统计学差异。FS-LASIK 术后短期使用强效糖皮质激素可迅速缓解眼表炎症,促进角膜愈合,减轻角膜水肿,加速角膜透明度恢复,而术后长期使用弱效糖皮质激素则效果不佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/f541af24fcc0/medi-103-e39667-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/8a8ceea6e964/medi-103-e39667-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/f541af24fcc0/medi-103-e39667-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/8a8ceea6e964/medi-103-e39667-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/0ea77ee4f822/medi-103-e39667-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/ab661cb93c26/medi-103-e39667-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa8f/11404958/f541af24fcc0/medi-103-e39667-g005.jpg

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