本文選題：Flap-free　切入點：Epi-LASIK　出處：《南華大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究典必殊及普南撲靈(普拉洛芬滴眼液)對去瓣準(zhǔn)分子激光上皮下角膜磨鑲術(shù)(Flap-free epipolis laser in-situ keratomileusis, Flap-free Epi-LASIK)術(shù)后疼痛、早期視力恢復(fù)、角膜上皮愈合、淚膜及Haze的影響。 方法:選取2009年10月至2010年4月在本院行Flap-free Epi-LASIK手術(shù)患者120例240眼。隨機分為試驗1組(典必殊滴眼液組)、試驗2組(普南撲靈和典必殊滴眼液組)和常規(guī)用藥組(對照組),對3組病例術(shù)后第1d、3d、5d、7d、15d及第1m、2m、3m、4m、6m術(shù)后角膜刺激癥狀、裸眼視力、最佳矯正視力、角膜上皮愈合、眼壓、淚膜破裂時間、淚液分泌試驗、淚液蕨類試驗、結(jié)膜印記細胞學(xué)檢查、Haze進行對比觀察,并行計算機圖像分析及對實驗結(jié)果進行統(tǒng)計學(xué)分析。 結(jié)果:1.角膜刺激癥狀:術(shù)后1d及3d試驗2組和常規(guī)用藥組之間角膜刺激癥狀差異有統(tǒng)計學(xué)意義(t值分別為4.31, 2.77,P0.01),術(shù)后1d及3d試驗2組和試驗1組之間角膜刺激癥狀差異有統(tǒng)計學(xué)意義(t值分別為2.56, 2.14, P0.05),而在術(shù)后第5d及第7d各組間差異無統(tǒng)計學(xué)意義(P0.05)。2.角膜上皮愈合:術(shù)后1d,試驗1組、試驗2組與常規(guī)用藥組所有病例角膜表面均有一層新生上皮覆蓋;術(shù)后3d,試驗1組、試驗2組與常規(guī)用藥組所有病例角膜上皮逐層愈合。術(shù)后5d大部分基本愈合,7d大部分愈合,平均愈合時間各組間差異無統(tǒng)計學(xué)意義(P0.05)。3.視力:試驗1組和常規(guī)用藥組分別有68%(27例54眼)和70%患者(28例56眼)術(shù)后1d、3d視力檢查不能配合。其余病例術(shù)后1d、3d視力恢復(fù)試驗2組與試驗1組和常規(guī)用藥組比較,差異有統(tǒng)計學(xué)意義(t值分別為2.90,2.17;3.71, 2.49,P0.01);術(shù)后5d、1m、3m各組間比較差異無統(tǒng)計學(xué)意義(P0.05)。4.眼壓:術(shù)前各組眼壓各組間差異無統(tǒng)計學(xué)意義(P0.05);術(shù)后眼壓均低于術(shù)前水平,與術(shù)前比較有統(tǒng)計學(xué)意義(P0.05),術(shù)后1m、4m、6m眼壓各組間差異無統(tǒng)計學(xué)意義(P0.05)。5.淚膜破裂時間(BUT):術(shù)后7d,1m各組BUT與術(shù)前比較差異有統(tǒng)計學(xué)意義(P0.05),術(shù)后1m以后逐漸增加,術(shù)后6m各組與術(shù)前比較差異無統(tǒng)計學(xué)意義(P0.05),術(shù)后7d、1m、3m、6m各組間差異無統(tǒng)計學(xué)意義(P0.05)。6.淚液分泌試驗I (SchirmerⅠ試驗):術(shù)后7d,1m各組淚液分泌量較術(shù)前減少,與術(shù)前比較差異有統(tǒng)計學(xué)意義(P0.05), 1m以后淚液分泌量逐步恢復(fù),術(shù)后6m各組與術(shù)前比較差異無統(tǒng)計學(xué)意義(P0.05),術(shù)后7d、1m、3m、6m各組間差異無統(tǒng)計學(xué)意義(P0.05)。7.淚液蕨類試驗(MFT):術(shù)后1m、3m、4m、6m各組淚液羊齒狀試驗差異無統(tǒng)計學(xué)意義(P0.05)。術(shù)后1m、3m、4m各組與術(shù)前比較差異有統(tǒng)計學(xué)意義(P0.05)。術(shù)后6m各組與術(shù)前比較差異無統(tǒng)計學(xué)意義(P0.05)。8.結(jié)膜印記細胞學(xué)檢查:術(shù)后1m、3m、4m、6m各組印記細胞學(xué)檢查差異無統(tǒng)計學(xué)意義(P0.05);術(shù)后1m、3m、4m、6m各組與術(shù)前比較差異有統(tǒng)計學(xué)意義(P0.05)。9.Haze:術(shù)后10d至1m可見到Haze發(fā)生,術(shù)后1m達到高峰,術(shù)后6m左右逐漸減輕或消失,術(shù)后7d、1m、3m、6m各組間差異無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論: 1.Flap-free Epi-LASIK術(shù)前術(shù)后聯(lián)合應(yīng)用典必殊和普南撲靈可明顯減輕患者術(shù)后的疼痛,促進早期視力恢復(fù)。 2.Flap-free Epi-LASIK術(shù)前術(shù)后聯(lián)合應(yīng)用典必殊和普南撲靈對角膜上皮愈合、眼壓、Haze無明顯影響。 3.Flap-free Epi-LASIK術(shù)后早期各組淚膜穩(wěn)定性下降、淚液蕨類試驗蕨樣級別及結(jié)膜鱗狀化生級別增高;淚膜穩(wěn)定性、淚液分泌量、淚液蕨類試驗、結(jié)膜印記細胞學(xué)檢查在術(shù)后6個月時基本恢復(fù)到術(shù)前水平,提示早期聯(lián)合應(yīng)用典必殊和普南撲靈是安全有效的。
[Abstract]:Objective: To study the effect of TobraDex and pranopulin (Pranoprofen Eye Drops) to flap excimer laser epithelial keratomileusis (Flap-free Epipolis laser in-situ keratomileusis, Flap-free Epi-LASIK) postoperative pain, early recovery of visual acuity, corneal epithelial healing, effect of tear film and Haze.
Methods: from October 2009 to April 2010 in our hospital were performed Flap-free Epi-LASIK surgery in 120 eyes of 240 patients were randomly divided into experimental group 1 (TobraDex group), group 2 (pranopulin and TobraDex group) and conventional treatment group (control group), 3 cases of after the 1D, 3D, 5D, 7d, 15d and 1m, 2m, 3M, 4m, 6m postoperative corneal irritation, uncorrected visual acuity, best corrected visual acuity, intraocular pressure, corneal epithelial healing, tear break-up time, Schirmer test, tear fern test, conjunctival impression cytology, Haze were observed and compared. Parallel computer image analysis and statistical analysis of experimental results.
Results: 1. corneal irritation: between 1D and 3D after 2 test group and conventional medication group corneal irritation symptoms was statistically significant (t = 4.31, 2.77, P0.01), 1D and 3D test in 2 groups after operation and test between the 1 groups of corneal irritation was statistically significant (t = 2.56, 2.14, P0.05), and no significant difference in postoperative 5D and 7d difference between the groups (P0.05):.2. corneal epithelial healing after 1D, the test group 1, test group 2 and control group all cases of corneal surface have a layer of the epithelium covering; 3D after the operation, the test group 1, test the 2 group and the control group in all cases of corneal epithelial healing layer 5D postoperatively. The most basic healing, 7d most healing, the average healing time difference between groups was not statistically significant (P0.05).3. vision: experiment group 1 and control group were 68% (27 cases, 54 eyes) and 70% patients (28 eyes of 56 cases after 1D, 3D) 鍔涙鏌ヤ笉鑳介厤鍚，

本文編號：1594101