|
|
|
| Comparison of the Clinical Effects of Bromfenac Sodium and Fluorometholone after LASEK Surgery |
| Kun Yang, Weili Geng |
| Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin 300020, China |
|
|
|
|
Abstract Objective: To compare the effectiveness of bromfenac sodium and fluorometholone eye drops on relieving corneal irritation and its safety in clinical applications after laser epithelial keratomileusis (LASEK) surgery. Methods: This was a prospective randomized, controlled study. A total of 60 patients (120 eyes) who underwent LASEK surgery from April 2017 to February 2018 in Tianjin Eye Hosptial were divided randomly into a bromfenac sodium group and a fluorometholone group according to the random number table, 30 patients (60 eyes) were included in each group. In the first week after the surgery, the bromfenac sodium group was given 0.1% bromfenac sodium eye drops twice a day, and then from the second week, this eye drops changed to 4 times per day for 1 month and 2 times per day in the following month. While the fluorometholone group was given 0.3% sodium hyaluronate eye drops twice a day in the first week after the surgery, then the eye drops changed to 0.1% fluorometholone by giving 4 times per day, which was gradually tapered in every month to the end. Corneal irritation and epithelial healing were evaluated at 1 d, 2 d, 3 d and 5 d after surgery. Examinations of uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, slit lamp, Schirmer Ⅰ test (SⅠT), tear film break-up time (BUT) and corneal epithelium integrity evaluation were performed 1 week, 1 month and 3 months after surgery. An intraocular pressure (IOP) examination was performed 1 week, 2 weeks, 1 month, 3 months and 4 months. The data were analyzed by repeated measures ANOVA, independent sample t-test and Mann-Whitney U test. Results: The scores for corneal irritation in the bromfenac sodium group were significantly lower than those in the fluorometholone group after surgery (Fgroups=7.8, P=0.018; Ftimes=121.7, P<0.001; Finteraction=273.4, P<0.001). At 1 month after surgery, the mean visual acuity of both groups recovered to 1.0 or better. There were no statistically significant differences in UCVA, BCVA or refraction between the two groups. At 1 month after surgery, there were 6 cases (10%) of corneal haze in the bromfenac sodium group while there were 2 cases (3%) in the fluorometholone group. The correction of IOP in the bromfenac sodium group after surgery were all below 21 mmHg, while there were 5 cases (9%) of high IOP at 2 weeks and 3 cases (5%) at 1 month in the fluorometholone group. After 3 months, both SⅠT and BUT in the two groups returned to normal levels, and the difference was not statistically significant. After 3 months, the corneal epithelium had totally recovered in most of the patients in the two groups. There was no statistically significant difference between the two groups. Conclusions: Bromfenac sodium eye drops can effectively alleviate corneal irritation after LASEK surgery. It is safe and effective for the recovery of vision and anti-inflammatory effects. Furthermore, bromfenac sodium can reduce the risk of postoperative high intraocular pressure caused by glucocorticoids. However, the incidence of corneal haze is slightly higher.
|
|
Received: 24 February 2019
|
|
Corresponding Authors:
Corresponding author: Kun Yang, Tianjin Eye Hospital, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin 300020, China (Email: yangkun997@163.com)
|
|
|
|
| [1] |
Kuryan J, Cheema A, Chuck RS.Laser-assisted subepithelial keratectomy (LASEK) versus laser-assisted in-situ keratomileusis (LASIK) for correcting myopia: Reviews. John Wiley & Sons Ltd, 2017, 2: D11080. DOI: 10.1002/14651858.CD011080.pub2.
|
| [2] |
姜洋, 李莹, 金玉梅, 等. SMILE术后应用0.1%溴芬酸钠滴眼液与0.1%地塞米松-妥布霉素滴眼液的疗效比较. 中华眼科杂志, 2017, 53(1): 18-22. DOI: 10.3760/cma.j.issn.0412-4081. 2017.01.005.
|
| [3] |
Giannaccare G, Finzi A, Sebastiani S, et al.The comparative efficacy and tolerability of diclofenac 0.1% and bromfenac 0.09% ophthalmic solutions after cataract surgery. Curr Eye Res, 2018, 43(12): 1445-1453. DOI: 10.1080/02713683.2018. 1501489.
|
| [4] |
Cleaveland NA, De Mann DW, Carlson NE, et al.Efficacy and perioperative timing of bromfenac in the management of ocular discomfort after femtosecond laser-assisted laser in situ keratomileusis. J Cataract Refract Surg, 2017, 43(2): 183-188. DOI: 10.1016/j.jcrs.2016.11.042.
|
| [5] |
许艳, 赵旭, 张丰菊, 等. 0.1%溴芬酸钠水合物滴眼液在准分子激光原位角膜磨镶术后的临床疗效观察. 中华眼科杂志, 2013, 49(4): 320-326. DOI: 10.3760/cma.j.issn.0412-4081.2013. 04.007.
|
| [6] |
Li H, Wang Y, Dou R, et al.Intraocular pressure changes and relationship with corneal biomechanics after SMILE and FS-LASIK. Invest Ophthalmol Vis Sci, 2016, 57(10): 4180-4186. DOI: 10.1167/iovs.16-19615.
|
| [7] |
赵家良, 黎晓新, 董冬生, 等. 普拉洛芬滴眼液治疗白内障术后炎症和非感染性眼前段炎症的临床评价. 眼科研究, 2000, 18(6): 560-564. DOI: 10.3760/cma.j.issn.2095-0160.2000. 06.027.
|
| [8] |
Dooley I, D'Arcy F, O'Keefe M. Comparison of dry-eye disease severity after laser in situ keratomileusis and laser-assisted subepithelial keratectomy. J Cataract Refract Surg, 2012, 38(6): 1058-1064. DOI: 10.1016/j.jcrs.2012.01.028.
|
| [9] |
Fantes FE, Hanna KD, Waring GO 3rd,et al. Wound healing after excimer laser keratomileusis (photorefractive keratectomy) in monkeys. Arch Ophthalmol, 1990, 108(5): 665-675.
|
| [10] |
Phulke S, Kaushik S, Kaur S, et al.Steroid-induced glaucoma: An avoidable irreversible blindness. J Curr Glaucoma Pract, 2017, 11(2): 67-72. DOI: 10.5005/jp-journals-l0028-1226.
|
| [11] |
白继. 角膜屈光手术医师应注意抗炎类滴眼液对术后角膜生物力学的影响. 中华实验眼科杂志, 2012, 30(12): 1057-1059. DOI: 10.3760/cma.j.issn.2095-0160.2012.12.001.
|
| [12] |
陈开建, 白继, 张国伟, 等. 非甾体与甾体类抗炎药物在薄瓣LASIK术后的疗效比较. 中华眼视光学与视觉科学杂志, 2015, 17(11): 654-658. DOI: 10.3760/cma.j.issn.1674-845X. 2015.11.004.
|
| [13] |
李莹. 新一代非甾体药物—溴芬酸钠在屈光手术的应用及注意事项. 中华实验眼科杂志, 2012, 30(11): 965-967. DOI: 10.3760/cma.j.issn.2095-0160.2012.11.002.
|
| [14] |
刘曼丽, 刘泉, 王丹阳, 等. 0.1%溴芬酸钠滴眼液在SMILE术后的早期疗效. 中华眼视光学与视觉科学杂志, 2014, 16(9): 551-556. DOI: 10.3760/cma.j.issn.1674-845X.2014.09.009.
|
|
|
|
2019, Vol. 21 
