准分子激光屈光性角膜切削术后角膜混浊的局部应用干扰素α 2b。墨尔本准分子激光研究小组。

Topical interferon alpha 2b for corneal haze after excimer laser photorefractive keratectomy. The Melbourne Excimer Laser Group.

作者信息

Gillies M C, Garrett S K, Shina S M, Morlet N, Taylor H R

机构信息

University of Department of Ophthalmology, Sydney Eye Hospital, Woolloomooloo NSW, Australia.

出版信息

J Cataract Refract Surg. 1996 Sep;22(7):891-900. doi: 10.1016/s0886-3350(96)80188-x.

DOI:10.1016/s0886-3350(96)80188-x

PMID:9041079

Abstract

PURPOSE

To determine whether topical interferon alpha 2b (IFN-alpha) prevents corneal haze after excimer laser photorefractive keratectomy (PRK).

SETTING

Tertiary referral ophthalmic hospital.

METHOD

A prospective, double-blind, placebo-controlled, randomized study of 31 patients was undertaken. After surgery in a single institution, patients received a drop of either a placebo or IFN-alpha (5 x 10(6) IU/ml) four times daily for 4 weeks. The main outcome measures were corneal haze, refraction, and visual acuity.

RESULTS

The major side effect of interferon alpha treatment was a significant delay in epithelial healing by a mean of 2 days. The means of the average post-treatment clinical scores for haze in all patients up to 12 months after surgery were 0.46 +/- 0.25 for the IFN-alpha group and 0.64 +/- 0.43 for the placebo group (P = .20). Of patients with a correction of greater than 5.00 diopters (D), the IFN-alpha group had significantly less haze over the course of the study (0.39 +/- 0.23 versus 0.98 +/- 0.50; P = .03). After 12 months, the mean absolute spherical equivalent in the two groups was not significantly different (1.02 +/- 1.13 D versus 1.44 +/- 2.64 D). There was a tendency toward better uncorrected visual acuity in the INF-alpha group (P < .10, Kolmogorov-Smirnov).

CONCLUSION

Topical IFN-alpha may merit further investigation as a treatment to reduce corneal haze after excimer laser PRK for corrections greater than 5.00 D.

摘要

目的

确定局部应用干扰素α2b（IFN-α）能否预防准分子激光屈光性角膜切削术（PRK）后角膜混浊。

设置

三级转诊眼科医院。

方法

对31例患者进行了一项前瞻性、双盲、安慰剂对照、随机研究。在单一机构进行手术后，患者每天4次，每次滴一滴安慰剂或IFN-α（5×10⁶IU/ml），持续4周。主要观察指标为角膜混浊、屈光和视力。

结果

干扰素α治疗的主要副作用是上皮愈合显著延迟，平均延迟2天。术后12个月内，所有患者治疗后角膜混浊临床评分的平均值，IFN-α组为0.46±0.25，安慰剂组为0.64±0.43（P = 0.20）。在矫正度数大于5.00屈光度（D）的患者中，IFN-α组在研究过程中角膜混浊明显较少（0.39±0.23对0.98±0.50；P = 0.03）。12个月后，两组的平均绝对球镜当量无显著差异（1.02±1.13 D对1.44±2.64 D）。IFN-α组的未矫正视力有更好的趋势（P < 0.10，柯尔莫哥洛夫-斯米尔诺夫检验）。