临床研究
ENGLISH ABSTRACT
玻璃酸钠滴眼液点眼对中重度干眼及无干眼IOL-Master 700生物测量参数的影响
李景兰
叶子
马天驹
高艺
杨青华
李朝辉
作者及单位信息
·
DOI: 10.3760/cma.j.issn.2095-0160.2020.03.006
Effect of sodium hyaluronate eye drops on IOL-Master 700 measurement parameters in moderate and severe dry eye and non dry eye patients
Li Jinglan
Ye Zi
Ma Tianju
Gao Yi
Yang Qinghua
Li Zhaohui
Authors Info & Affiliations
Li Jinglan
Department of Ophthalmology, Chinese PLA General Hospital, Beijing 100853, China
Ye Zi
Ma Tianju
Gao Yi
Yang Qinghua
Li Zhaohui
·
DOI: 10.3760/cma.j.issn.2095-0160.2020.03.006
0
0
0
0
0
0
PDF下载
APP内阅读
摘要

目的研究玻璃酸钠滴眼液点眼对中重度干眼及无干眼者IOL-Master 700生物测量参数的影响。

方法采用非随机对照临床研究方法。招募2018年8月1日至2019年1月1日于解放军总医院第一医学中心眼科门诊就诊的中重度干眼患者作为中重度干眼组,同期选取无干眼者作为无干眼组,每组各40例,均以右眼为试验眼。所有受试者分别于质量分数0.1%玻璃酸钠滴眼液点眼前、点眼后5、10及15 min行IOL-Master 700生物测量,分析2个组玻璃酸钠点眼前后不同时间眼轴长度(AL)、中央角膜厚度(CCT)、角膜曲率、人工晶状体(IOL)度数的变化。

结果中重度干眼组CCT、K1和K2均大于无干眼组,差异均有统计学意义(均P<0.05)。中重度干眼组玻璃酸钠滴眼液点眼后5 min和10 min,AL、CCT及IOL度数较点眼前增大,K1较点眼前减小,差异均有统计学意义(均P<0.05/3);点眼后5 min,17.5%(7/40)中重度干眼患者的IOL度数增大0.5 D。点眼后10 min,22.5%(9/40)的中重度患者IOL度数增大0.5 D或1.0 D。点眼后15 min,各IOL-Master测量参数与点眼前比较,差异均无统计学意义(均P>0.05)。无干眼组点眼后5 min AL和CCT较点眼前增大,IOL度数较点眼前减小,差异均有统计学意义(均P<0.01)。点眼后10 min及15 min,AL和CCT较点眼前增大,差异均有统计学意义(均P<0.05/3),但IOL度数比较差异无统计学意义(均P>0.05)。

结论玻璃酸钠滴眼液点眼后5~10 min IOL-Master生物测量中重度干眼患者IOL度数增大,点眼后5 min内无干眼者IOL度数减小,该结果对临床上IOL-Master的正确使用有指导意义。

干眼;人工泪液;白内障;IOL-Master;人工晶状体度数
ABSTRACT

ObjectiveTo assess the changes in IOL-Master 700 parameters after administering sodium hyaluronate eye drops to moderate and severe dry eye and non-dry eye patients.

MethodsNon-randomized controlled clinical research was performed.Patients with moderate and severe dry eye and non dry eye were enrolled in this study, with 40 patients in each group.All patients underwent IOL-Master 700 bioassay before and 5, 10 and 15 minutes after the administration of 0.1% sodium hyaluronate eye drops.The differences in axial length (AL), central corneal thickness (CCT), corneal curvature, and intraocular lens (IOL) were compared before and after the administration.All subjects signed informed consent.

ResultsIn the dry eye group, the AL, CCT and IOL power were increased and the K1 were decreased at 5 and 10 minutes after administering sodium hyaluronate eye drops (P<0.05/3). IOL power of 17.5% increased by 0.5 D at 5 minutes after administering sodium hyaluronate eye drops.Further, 22.5% IOL power increased by 0.5 D or 1.0 D at 10 minutes after administering sodium hyalruonate eye drops.At 15 minutes after the administration, the IOL-Master parameters returned to the pre-intervention level.For the non-dry eye group, the AL and CCT were increased at 5 minutes after administering sodium hyalruonate eye drops, and the IOL power was decreased (P<0.01). The IOL power was decreased by a maximum of 0.5 D. At 10 and 15 minutes after administering sodium hyalruonate eye drops, the AL and CCT were significantly higher than those before the administration (all at P<0.05/3), but there was no significant change in IOL power (P>0.05).

ConclusionsThe IOL power of moderate and severe dry eye patients is increased at 5-10 minutes after administering sodium hyaluronate eye drops, and the IOL power of non-dry eye patients is decreased within 5 minutes after the administration.

Dry eye;Artificial tear;Cataract;IOL-Master;Intraocular lens power
Li Zhaohui, Email: mocdef.3ab6175093210731

Trial Registration:Chinese Clinical Trial Registry (ChiCTR-IOR-15005958)

引用本文

李景兰,叶子,马天驹,等. 玻璃酸钠滴眼液点眼对中重度干眼及无干眼IOL-Master 700生物测量参数的影响[J]. 中华实验眼科杂志,2020,38(03):186-191.

DOI:10.3760/cma.j.issn.2095-0160.2020.03.006

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价
随着人们生活环境的改变,白内障合并干眼的患者在临床上越来越常见。目前,精确计算及预测白内障手术患者的人工晶状体(intraocular lens,IOL)度数,减少术后屈光误差,提高视觉质量是白内障手术的发展趋势。IOL-Master在白内障术前生物测量方面应用较多,其测量眼轴长度(axial length,AL)、角膜曲率的重复性和可信度较高,但是由于合并干眼的白内障患者眼表面形态的不规则及泪膜稳定性的下降等因素,可产生生物测量误差,导致术后实际屈光状态与预计屈光状态的偏差。国际泪膜与眼表协会(Tear Film & Ocular Surface Society,TFOS)2017年的干眼专家共识(Dry Eye Workshop Ⅱ,DEWS Ⅱ)中提出,以干眼症状为基础的患病率研究呈现多样化,患病率为6.5%~39.2%,女性高于男性,亚洲人高于高加索人;中国人群的研究表明,同时具有干眼症状与体征的干眼患者在人群中的比例达13.55% [ 1 , 2 ]。面对庞大的干眼患者群体,精准屈光性白内障手术面临挑战。临床上,补充人工泪液是干眼患者较常用的治疗手段,能够改善干眼患者的刺激症状,使干眼患者不规则的角膜表面变光滑,视功能得到改善 [ 3 ]。在IOL-Master测量前滴入人工泪液是许多操作者的经验性做法,那么干眼与非干眼人群在生物测量参数上是否存在差异,测量前滴入人工泪液这一做法是否能够提高生物测量的准确性,进而影响最终由生物测量参数计算而来的IOL度数,目前尚不清楚。故本研究纳入中重度干眼和非干眼人群,采用IOL-Master 700研究玻璃酸钠滴眼液点眼前后各生物测量参数的变化。
试读结束,您可以通过登录机构账户或个人账户后获取全文阅读权限。
参考文献
[1]
Stapleton F , Alves M , Bunya VY ,et al. TFOS DEWS II Epidemiology Report[J]. Ocul Surf, 2017,15(3):334-365. DOI: 10.1016/j.jtos.2017.05.003 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
晏晓明解读国际泪膜与眼表协会2017年干眼专家共识中的干眼流行病学[J]中华实验眼科杂志 2019. 37(3):226-228. DOI: 10.3760/cma.j.issn.2095-0160.2019.03.013 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Song P , Xia W , Wang M ,et al. Variations of dry eye disease prevalence by age, sex and geographic characteristics in China:a systematic review and meta-analysis[J/OL]. J Glob Health, 2018,8(2):020503[2019-02-11]. http://www.ncbi.nlm.nih.gov/pubmed/30206477. DOI: 10.7189/jogh.08.020503 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
Wozniak PA , Schmidl D , Bata AM ,et al. Effect of different lubricant eye gels on tear film thickness as measured with ultrahigh-resolution optical coherence tomography[J]. Acta Ophthalmol, 2017,95(4):e307-e313. DOI: 10.1111/aos.13342 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Amparo F , Schaumberg DA , Dana R . Comparison of two questionnaires for dry eye symptom assessment:the ocular surface disease index and the symptom assessment in dry eye[J]. Ophthalmology, 2015,122(7):1498-1503. DOI: 10.1016/j.ophtha.2015.02.037 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Koh S . Mechanisms of visual disturbance in dry eye[J]. Cornea, 2016,35Suppl 1:S83-S88. DOI: 10.1097/ICO.0000000000000998 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Koh S . Irregular astigmatism and higher-order aberrations in eyes with dry eye disease[J]. Invest Ophthalmol Vis Sci, 2018,59(14):DES36-DES40. DOI: 10.1167/iovs.17-23500 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Koh S , Tung CI , Inoue Y ,et al. Effects of tear film dynamics on quality of vision[J]. Br J Ophthalmol, 2018,102(12):1615-1620. DOI: 10.1136/bjophthalmol-2018-312333 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Deinema LA , Vingrys AJ , Chinnery HR ,et al. Optical coherence tomography reveals changes to corneal reflectivity and thickness in individuals with tear hyperosmolarity[J/OL]. Transl Vis Sci Technol, 2017,6(3):6[2019-02-13]. http://www.ncbi.nlm.nih.gov/pubmed/28553560. DOI: 10.1167/tvst.6.3.6 .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Sanchis-Gimeno JA , Lleó-Pérez A , Alonso L ,et al. Reduced corneal thickness values in postmenopausal women with dry eye[J]. Cornea, 2005,24(1):39-44. DOI: 10.1097/01.ico.0000138836.45070.0f .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Liu Z , Pflugfelder SC . Corneal thickness is reduced in dry eye[J]. Cornea, 1999,18(4):403-407. DOI: V10.2147/OPTH.S119343 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Akyol-Salman I , Azizi S , Mumcu U ,et al. Central corneal thickness in patients with meibomian gland dysfunction[J]. Clin Exp Optom, 2011,94(5):464-467. DOI: 10.1111/j.1444-0938.2011.00631.x .
返回引文位置Google Scholar
百度学术
万方数据
[13]
兰长骏彭悦廖萱扫频光相干断层扫描生物测量仪在白内障中的应用[J]中华实验眼科杂志 201937(2):123-128. DOI: 10.3760/cma.j.issn.2095-0160.2019.02.010 .
返回引文位置Google Scholar
百度学术
万方数据
Lan CJ , Peng Y , Liao X . Application of swept-source optical coherence tomography biometer in cataract[J]. Chin J Exp Ophthalmol, 2019,37(2):123-128. DOI: 10.3760/cma.j.issn.2095-0160.2019.02.010 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Shajari M , Kolb CM , Petermann K ,et al. Comparison of 9 modern intraocular lens power calculation formulas for a quadrifocal intraocular lens[J]. J Cataract Refract Surg , 2018,44(8):942-948. DOI: 10.1016/j.jcrs.2018.05.021 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Melles RB , Holladay JT , Chang WJ . Accuracy of intraocular lens calculation formulas[J]. Ophthalmology, 2018,125(2):169-178. DOI: 10.1016/j.ophtha.2017.08.027 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Afsharkhamseh N , Movahedan A , Motahari H ,et al. Cataract surgery in patients with ocular surface disease:An update in clinical diagnosis and treatment[J]. Saudi J Ophthalmol, 2014,28(3):164-167. DOI: 10.1016/j.sjopt.2014.06.013 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Asbell P , Vingrys AJ , Tan J ,et al. Clinical outcomes of fixed versus as-needed use of artificial tears in dry eye disease:a 6-week, observer-masked phase 4 clinical trial[J]. Invest Ophthalmol Vis Sci, 2018,59(6):2275-2280. DOI: 10.1167/iovs.17-23733 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Wang TJ , Wang IJ , Ho JD ,et al. Comparison of the clinical effects of carbomer-based lipid-containing gel and hydroxypropyl-guar gel artificial tear formulations in patients with dry eye syndrome:a 4-week, prospective, open-label, randomized, parallel-group, noninferiority study[J]. Clin Ther, 2010,32(1):44-52. DOI: 10.1016/j.clinthera.2010.01.024 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Afsharkhamseh N , Movahedan A , Motahari H ,et al. Cataract surgery in patients with ocular surface disease:An update in clinical diagnosis and treatment[J]. Saudi J Ophthalmol, 2014,28(3):164-167. DOI: 10.1016/j.sjopt.2014.06.013 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Epitropoulos AT , Matossian C , Berdy GJ ,et al. Effect of tear osmolarity on repeatability of keratometry for cataract surgery planning[J]. J Cataract Refract Surg, 2015,41(8):1672-1677. DOI: 10.1016/j.jcrs.2015.01.016 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Lu N , Lin F , Huang Z ,et al. Changes of corneal wavefront aberrations in dry eye patients after treatment with artificial lubricant drops[J/OL]. J Ophthalmol, 2016,2016:1342056[2019-02-10]. http://www.ncbi.nlm.nih.gov/pubmed/27051526. DOI: 10.1155/2016/1342056 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Vandermeer G , Chamy Y , Pisella PJ . Comparison of objective optical quality measured by double-pass aberrometry in patients with moderate dry eye:Normal saline vs.artificial tears:A pilot study[J]. J Fr Ophtalmol, 2018,41(2):e51-e57. DOI: 10.1016/j.jfo.2017.12.001 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
洪莲花李英俊干眼对年龄相关性白内障患者人工晶状体度数测量和计算准确性的影响[J]中华实验眼科杂志 201634(2):170-174. DOI: 10.3760/cma.j.issn.2095-0160.2016.02.016 .
返回引文位置Google Scholar
百度学术
万方数据
Hong LH , Li YJ . Pilot study on dry eye affecting the accuracy of intraocular lens power measurement in age-related cataract[J]. Chin J Exp Ophthalmol, 2016,34(2):170-174. DOI: 10.3760/cma.j.issn.2095-0160.2016.02.016 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Çakır B , Doğan E , Çelik E ,et al. Effects of artificial tear treatment on corneal epithelial thickness and corneal topography findings in dry eye patients[J]. J Fr Ophtalmol, 2018,41(5):407-411. DOI: 10.1016/j.jfo.2017.06.032 .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Schmidl D , Schmetterer L , Witkowska KJ ,et al. Tear film thickness after treatment with artificial tears in patients with moderate dry eye disease[J]. Cornea, 2015,34(4):421-426. DOI: 10.1097/ICO.0000000000000358 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Tung CI , Kottaiyan R , Koh S ,et al. Noninvasive, objective, multimodal tear dynamics evaluation of 5 over-the-counter tear drops in a randomized controlled trial[J]. Cornea, 2012,31(2):108-114. DOI: 10.1097/ICO.0b013e31821ea667 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
李朝辉,Email: mocdef.3ab6175093210731
B

中国临床试验注册中心(ChiCTR-IOR-15005958)

C
所有作者均声明不存在利益冲突
D
国家自然科学基金项目 (81870640、81670838)
北京市自然科学基金项目 (7182152)
院临床扶持基金项目 (2107FC-ZHCG-3003)
评论 (0条)
注册
登录
时间排序
暂无评论,发表第一条评论抢沙发
MedAI助手(体验版)
文档即答
智问智答
机器翻译
回答内容由人工智能生成,我社无法保证其准确性和完整性,该生成内容不代表我们的态度或观点,仅供参考。
生成快照
文献快照

你好,我可以帮助您更好的了解本文,请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持:

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号