Department of Ophthalmology, Zigong First People's Hospital, Zigong, Sichuan, China.
Department of Internal Medicine, Zigong First People's Hospital, Zigong, Sichuan, China.
Medicine (Baltimore). 2024 Sep 13;103(37):e39667. doi: 10.1097/MD.0000000000039667.
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.
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。