背景:屈光手术后干眼症(DED)的治疗在临床实践中可能具有挑战性,患者通常对传统的人工泪液表现出不完全的反应,尤其是当它并发眼痛时。因此,我们的目的是研究局部使用0.05%环孢素A和0.1%透明质酸钠联合治疗对传统人工泪液对眼部疼痛无反应的屈光手术后DED患者的疗效.
方法:我们招募了30例屈光手术后DED合并眼痛的患者,这些患者对传统人工泪液无反应。局部使用0.05%环孢菌素A和0.1%透明质酸钠3个月。他们在基线和1个月和3个月评估干眼症和眼部疼痛症状和客观参数。包括数值评级量表(NRS),神经性疼痛症状量表修改为眼睛(NPSI-Eye),泪液破裂时间(TBUT),SchirmerI测试(Sit),角膜荧光素染色(CFS),角膜敏感度,和角膜神经形态学。此外,使用Luminex测定法测量炎性细胞因子和神经肽的泪液水平。
结果:治疗3个月后,患者的眼表疾病指数(OSDI)有统计学意义的改善,TBUT,坐,CFS,和角膜敏感度(均P<0.01)使用线性混合模型。至于眼部疼痛参数,NRS和NPSI-Eye评分均显著降低(均P<0.05),且与OSDI和CFS评分呈正相关。此外,泪液IL-1β,IL-6和TNF-α水平改善优于治疗前(P分别为0.01、0.03、0.02)。
结论:屈光手术后合并眼痛的患者,联合局部用0.05%环孢素A和0.1%透明质酸钠治疗可改善泪膜稳定性,干眼症不适,和眼部疼痛,有效控制眼部炎症。
背景:注册号:NCT06043908。
BACKGROUND: The management of post-refractive surgery dry eye disease (DED) can be challenging in clinical practice, and patients usually show an incomplete response to traditional artificial tears, especially when it is complicated with ocular pain. Therefore, we aim to investigate the efficacy of combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment in post-refractive surgery DED patients with ocular pain unresponsive to traditional artificial tears.
METHODS: We enrolled 30 patients with post-refractive surgery DED with ocular pain who were unresponsive to traditional artificial tears. Topical 0.05% cyclosporine A and 0.1% sodium hyaluronate were used for 3 months. They were evaluated at baseline and 1 and 3 months for dry eye and ocular pain symptoms and objective parameters, including Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), tear break-up time (TBUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), corneal sensitivity, and corneal nerve morphology. In addition, tear levels of inflammatory cytokines and neuropeptides were measured using the Luminex assay.
RESULTS: After 3 months of treatment, patients showed a statistically significant improvement in the ocular surface disease index (OSDI), TBUT, SIt, CFS, and corneal sensitivity (all P < 0.01) using linear mixed models. As for ocular pain parameters, the NRS and NPSI-Eye scores were significantly reduced (both P < 0.05) and positively correlated with the OSDI and CFS scores. Additionally, tear IL-1β, IL-6, and TNF-α levels were improved better than pre-treatment (P = 0.01, 0.03, 0.02, respectively).
CONCLUSIONS: In patients with post-refractive surgery DED with ocular pain, combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment improved tear film stability, dry eye discomfort, and ocular pain, effectively controlling ocular inflammation.
BACKGROUND: Registration number: NCT06043908.