Ferguson Tanner J, Walton Kristen, Goertz John G, Baartman Brandon J
Vance Thompson Vision, Sioux Falls, SD, USA.
Vance Thompson Vision, Omaha, NE, USA.
Clin Ophthalmol. 2024 Oct 5;18:2777-2784. doi: 10.2147/OPTH.S474747. eCollection 2024.
To evaluate the use of varenicline solution nasal spray 0.03 mg (VNS) as a treatment option for the signs and symptoms of dry eye disease following photorefractive keratectomy (PRK).
Subjects electing to undergo PRK were randomized to VNS (study group) or vehicle (control group) twice daily and started treatment with VNS 28 days prior to surgery with continued use of the treatment for 84 days after PRK. After starting treatment, subjects were seen on the day of the procedure and postoperatively at days 2, 3, 4, 7, 28 and 84. The primary outcome measure was the mean change in NEI-VFQ-25, a dry eye item questionnaire, from baseline to day 84. The second primary outcome measure was the rate of corneal epithelial healing following PRK. Secondary outcome measures included eye dryness score (EDS), tear break up time and visual outcomes. The use of rescue therapy was also evaluated.
Twenty-one subjects were enrolled in the study group, and twenty subjects were enrolled in the control group. Results from the NEI-VFQ-25 questionnaire revealed positive results in both groups and the between-group difference was not statistically significant (P > 0.05). There was a trend towards faster re-epithelialization in patients treated with VNS vs placebo, where 100% epithelial closure was observed by Day 3 in the VNS group versus Day 4 in the control group; however, the between-group difference was not statistically significant (P > 0.05). Three subjects had rescue therapy in the control group while a single subject was rescued in the study group. A higher rate of eyes achieved vision of 20/16 or better in the study group (82.5%) versus the control group (72.5%) at 3 months.
VNS is a favorable dry eye treatment option for patients following PRK, particularly in patients hoping to avoid additional topical medications or punctal occlusion. The higher percentage of eyes with UCDVA of 20/16 or better in the treatment group may suggest optimization of epithelial recovery after PRK.
评估0.03毫克伐尼克兰溶液鼻喷雾剂（VNS）作为准分子激光角膜切削术（PRK）后干眼症体征和症状的一种治疗选择的效果。
选择接受PRK的受试者被随机分为VNS组（研究组）或赋形剂组（对照组），每天两次，在手术前28天开始使用VNS治疗，并在PRK后持续使用84天。开始治疗后，在手术当天以及术后第2、3、4、7、28和84天对受试者进行观察。主要结局指标是干眼项目问卷NEI-VFQ-25从基线到第84天的平均变化。第二个主要结局指标是PRK后角膜上皮愈合率。次要结局指标包括眼干评分（EDS）、泪膜破裂时间和视力结果。还评估了急救治疗的使用情况。
研究组纳入21名受试者，对照组纳入20名受试者。NEI-VFQ-25问卷的结果显示两组均有阳性结果，组间差异无统计学意义（P>0.05）。与安慰剂组相比，接受VNS治疗的患者角膜上皮再形成有加快的趋势，VNS组在第3天观察到100%上皮闭合，而对照组在第4天；然而，组间差异无统计学意义（P>0.05）。对照组有3名受试者接受了急救治疗，而研究组有1名受试者接受了急救治疗。在3个月时，研究组（82.5%）比对照组（72.5%）有更高比例的眼睛达到20/16或更好的视力。
VNS是PRK后患者干眼症的一种良好治疗选择，特别是对于希望避免额外局部用药或泪点封闭的患者。治疗组中最佳矫正视力（UCDVA）为20/16或更好的眼睛比例较高，这可能表明PRK后上皮恢复得到了优化。
