Effects of oxybuprocaine on the cornea and corneal epithelial thickness
FU Dan,GAO Ying,WANG Lin,PIAO Mingzi,ZHOU Xingtao,YU Zhiqiang
Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Myopia Key Laboratory of Health Ministry, Shanghai 200031, China; Department of Ophthalmology, Jinhua Hospital of Zhejiang University, Jinhua 321000, China. FU Dan and GAO Ying contributed equally to the article
Objective To investigate the influence of the topical anesthetic oxybuprocaine on corneal thickness (CT), corneal epithelial thickness (CET), and corneal uniformity among patients scheduled for corneal refractory surgery. Methods In this prospective self-controlled study, a total of 59 eyes of 30 consecutive patients presenting for SMILE in the Refractive Surgery Center during March 2016 were enrolled. The central (2 mm diameter), para-central (2-5 mm diameter), and peripheral (5-6 mm diameter) CT and CET were assessed by anterior segment optical coherence tomography before and after 30 minutes after the instillation of 0.4% oxybuprocaine prior to SMILE. Each area was divided into 8 regions. Values of the superior-inferior, nasal-temporal, range, and the standard deviation of the CET and CT were used to assess the uniformity of the cornea. Keratometry, astigmatism, eccentricity, central pupil thickness, and the thinnest point of the cornea were recorded by Pentacam. Paired t-test and contour analysis were used to detect anesthetic effects. Results While the CET of 3 eyes of 2 patients was significantly increased after oxybuprocaine, there was no significant effect overall on the CET of the entire study group. Central pupil thickness was 535.6±25.1 µm and 537.7±25.1 µm before and after the use of the topical anesthetic (t=-2.74, P＜0.01). There was a significant increase in CT in the infero-temporal area of the para-central region after oxybuprocaine. The distributions of CT and CET did not change significantly. Eccentricity values before and after oxybuprocaine were 0.56±0.10 diopter (D) and 0.57±0.10 D (t=-2.60, P＞0.05), respectively. There was no significant difference in astigmatism or thickness at the thinnest point before and after the use of the topical anesthetic. Conclusion The topical anesthetic oxybuprocaine had little influence on the thickness and shape of the cornea or corneal epithelium. However, some individuals can have a significant increase in CET after anesthetic eye drops are instilled. This requires a close observation by the surgeons.
付单,高颖,汪琳,朴明子,周行涛,于志强. 角膜屈光术前奥布卡因滴眼液对角膜及角膜上皮厚度的影响[J]. 中华眼视光学与视觉科学杂志, 2017, 19(1): 40-46.
FU Dan,GAO Ying,WANG Lin,PIAO Mingzi,ZHOU Xingtao,YU Zhiqiang. Effects of oxybuprocaine on the cornea and corneal epithelial thickness. Chinese Journal of Optometry Ophthalmology and Visual science, 2017, 19(1): 40-46. DOI: DOI:10.3760/cma.j.issn.1674-845X.2017.01.008
Vestergaard AH, Grauslund J, Ivarsen AR, et al. Efficacy, safety, predictability, contrast sensitivity, and aberrations after femtosecond laser lenticule extraction[J]. J Cataract Refract Surg,2014,40(3):403-411. DOI:10.1016/j.jcrs.2013.07.053.
[2]
Reinstein DZ, Carp GI, Archer TJ, et al. Outcomes of small incision lenticule extraction (SMILE) in low myopia[J]. J Refract Surg,2014,30(12):812-818. DOI:10.3928/1081597X-20141113-07.
[3]
Shah R, Shah S, Sengupta S. Results of small incision lenticule extraction: All-in-one femtosecond laser refractive surgery[J]. J Cataract Refract Surg,2011,37(1):127-137. DOI:10.1016/j.jcrs.2010.07.033.
[4]
Moshirfar M, McCaughey MV, Reinstein DZ, et al. Small-incision lenticule extraction[J]. J Cataract Refract Surg,2015,41(3):652- 665. DOI:10.1016/j.jcrs.2015.02.006.
[5]
Nada O, Marian A, Tran-Khanh N, et al. Effect of corneal hydration on the quality of the femtosecond laser anterior lamellar cut[J]. PLoS One,2014,9(6):e98852. DOI:10.1371/ journal.pone.0098852.
Rush SW, Matulich J, Biskup J, et al. Corneal Epithelial Thickness Measured by Manual Electronic Caliper Spectral Domain Optical Coherence Tomography: Distributions and Demographic Correlations in Preoperative Refractive Surgery Patients[J]. Asia Pac J Ophthalmol (Phila),2016,5(2):147-150. DOI:10.1097/APO.0000000000000166.
[10]
Wang JK, Huang TL, Su P, et al. Factors affecting corneal hysteresis in Taiwanese adults[J]. Eye Sci,2015,30(3):89-93.
[11]
Gür GS, Akman A, Kü?觭ük?觟dük A, et al. Non-Contact and Contact Tonometry in Corneal Edema[J]. Optom Vis Sci,2016, 93(1):50-56. DOI:10.1097/OPX.0000000000000744.
Li Y, Tan O, Brass R, et al. Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes[J]. Ophthalmology,2012,119(12):2425-2433. DOI:10.1016/j.ophtha.2012.06.023.
[16]
Kanellopoulos AJ, Chiridou M, Asimellis G. Optical coherence tomography-derived corneal thickness asymmetry indices: clinical reference study of normal eyes[J]. J Cataract Refract Surg,2014, 40(10):1603-1609. DOI:10.1016/j.jcrs.2014.01.041.
[17]
Kanellopoulos AJ, Asimellis G. In vivo three-dimensional corneal epithelium imaging in normal eyes by anterior-segment optical coherence tomography: a clinical reference study[J]. Cornea, 2013,32(11):1493-1498. DOI:10.1097/ICO.0b013e3182a15cee.
[18]
Patel S, Alió JL, Artola A. Changes in the refractive index of the human corneal stroma during laser in situ keratomileusis. Effects of exposure time and method used to create the flap[J]. J Cataract Refract Surg,2008,34(7):1077-1082. DOI:10.1016/ j.jcrs.2008.03.022.
[19]
Qian Y, Huang J, Zhou X, et al. Comparison of femtosecond laser small-incision lenticule extraction and laser-assisted subepithelial keratectomy to correct myopic astigmatism[J]. J Cataract Refract Surg,2015,41(11):2476-2486. DOI:10.1016/j.jcrs.2015.05.043.
[20]
Lu L, Reinach PS, Kao WW. Corneal epithelial wound healing[J]. Exp Biol Med (Maywood),2001,226(7):653-664.
[21]
Grant RL, Acosta D. A digitized fluorescence imaging study on the effects of local anesthetics on cytosolic calcium and mitochondrial membrane potential in cultured rabbit corneal epithelial cells[J]. Toxicol Appl Pharmacol,1994,129(1):23-35. DOI: 10.1006/taap.1994.1225.
[22]
Wu Z, Begley CG, Port N, et al. The Effects of Increasing Ocular Surface Stimulation on Blinking and Tear Secretion[J]. Invest Ophthalmol Vis Sci,2015,56(8):4211-4220. DOI:10.1167/ iovs.14-16313.
[23]
Asensio I, Rahhal SM, Alonso L, et al. Corneal thickness values before and after oxybuprocaine 0.4% eye drops[J]. Cornea,2003, 22(6):527-532.
Thiagarajah JR, Verkman AS. Aquaporin deletion in mice reduces corneal water permeability and delays restoration of transparency after swelling[J]. J Biol Chem,2002,277(21):19139- 19144. DOI:10.1074/jbc.M202071200.
[26]
Li Y, Tan O, Brass R, et al. Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes[J]. Ophthalmology,2012,119(12):2425-2433. DOI:10.1016/j.ophtha.2012.06.023.
Lazaridis A, Droutsas K, Sekundo W. Topographic analysis of the centration of the treatment zone after SMILE for myopia and comparison to FS-LASIK: subjective versus objective alignment[J]. J Refract Surg,2014,30(10):680-686. DOI:10.3928/ 1081597X-20140903-04.
浙公网安备 33030202001892号