冷敷疗法缓解经上皮准分子激光角膜切削术后疼痛的效果

doi:10.3760/cma.j.issn115909-20190902-00239

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Abstract Objective: To observe the clinical efficacy of cold compresses on eye masks after transepithelial excimer laser keratectomy (TPRK) to relieve postoperative discomfort. Methods: This was a prospective randomized controlled study. Eighty seven patients undergoing TPRK surgery in the Eye Hospital, Wenzhou Medical University at Zhijiang were randomly divided into a cold compress group and a control group from October 2018 to April 2019. The right eye was selected for observation in both groups. The cold compress group was given a 4 ℃ frozen silicone eye mask ice pack for 20 minutes during the postoperative observation period, and the rest was treated the same as the control group. The control group was routinely treated with no cold compress. Filled in the eye discomfort scale at 2 h, 1 d, 2 d, 3 d, and 5 d after surgery at a relatively fixed time each day, including blurred vision, photophobia, foreign body sensation, tearing, eye pain, itching, secretions and other postoperative discomforts. Corneal epithelial healing, vision, equivalent sphericity, haze, MTF cutoff, OSI and other indicators were evaluated on the 5 d, 12 d, 1 month and 3 months after surgery. Data were analyzed by repeated measures of variance, and independent sample t test. Results: At 2 hours after surgery, the photophobia, foreign body sensation, and eye pain scores between the two groups. There were statistically significant differences between the two groups (F=15.93, P<0.001; F=9.52, P=0.003; F=13.57, P<0.001). There was no statistically significant difference in blurred vision, tearing, itching, and secretions between the two groups. At 1 day after surgery, there was a statistically significant difference in visual blur between the two groups (F=9.69, P=0.003). There was no statistically significant difference in indicators of photophobia, foreign body sensation, tearing, eye pain, itching, and secretions. There was no statistically significant difference between the two groups at 2 days, 3 days, and 5 days after surgery. There were no significant differences in corneal epithelial healing, UCVA, equivalent spherical power, and corneal subepithelial haze between the two groups at 5 d, 12 d, 1 month, and 3 months. There was no significant difference in objective optical quality assessment between the two groups at 3 months after surgery. Conclusions: TPRK postoperative cold compress therapy can improve early postoperative pain, photophobia, and foreign body sensation. It has no significant effect on long-term vision recovery, and has no negative effect on corneal epithelial repair and visual quality recovery.

Key words： transepithelial excimer laser keratectomy pain cold compress visual quality

Received: 02 September 2019

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Corresponding Authors: Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310000, China (Email: idrshen@zju.edu.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.issn115909-20190902-00239 OR https://www.cjoovs.com/EN/Y2020/V22/I9/691

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