| Objective:To study the effects of Tobradex and Pranopulin Eye Drops to postopera- tive pain, early recovery of visual acuity, corneal epithelial healing, tear film,Haze of Flap-free epipolis laser in-situ keratomileusis (Flap-free epipolis laser in-situ keratomileusis,Flap-free Epi-LASIK).Methods:To select 240 eyes of 120 Flap-free Epi-LASIK surgery patients in our hospital from October 2009 to April 2010.Randomly divided them into group 1 (tobradex eye drops group), group 2 (pranopulin eye drops and tobradex eye drops group) and conventional treatment group (control group);comparative observation of corneal irritation,uncorrected visual acuity,best corrected visual acuity,corneal epith- elial healing, intraocular pressure, tear breakup time, tear Secretion test, tear fern test and Haze of postoperative patients of the 3 groups in postoperative 1d,3d, 5d, 7d, 15d and 1m,2m,3m,4m,6m;the line computer image analysis were compared and the results were statistically analyzed.Results:1.corneal irritation :In postoperative 1d and 3d ,the difference of corneal irritation between group 2 and conventional treatment group was significant(t values were 4.31, 2.77, P<0.01).In postoperative 1d and 3d,the difference of corneal irritation between group 1 and conventional treatment group was significant(t values were 2.56,2.14,P<0.05). and in postoperative 5d and 7d,the difference between each group was no significant (P>0.05).2.corneal epithelial wound healing:In postoperative 1d, all cases of group 1,group 2 and the conventional group, the corneal surface covered by a layer of new epithelium; in postoperative 3d, all cases of the corneal epithelial layer get to heal; in postoperative 5d,most of the corneal epithelial wound healing basically healed;in postoperative 7d, most of the corneal epithelial wound healing healed; the average healing time among the groups was no significant difference (P>0.05).3.vision: In postoperative 1d and 3d,group 1 was 68% (54 eyes of 27 cases) and conventional treatment group was 70% of patients (28 cases 56 eyes) whicht can not match to examine;the remaining cases of group 2 compare to group 1 and conventional treatment group the difference was statistically significant (t values were 2.90,2.17; 3.71,2.49,P<0.01);in postoperative 5d,1m,3m, the difference among each group was not significant(P>0.05).4.intraocular pressure:In preoperative the difference between each group was not significant (P>0.05);the IOP levels in postoperative were lower than in preoperative 1m,4m,6m,the difference among each group was not significant(P>0.05).5.the tear breakup time (BUT):In postoperative 7d,1m the BUT of postoperative is short than the BUT of preoperative,the difference was significant(P<0.05).In postoperative 1m,the BUT gradually increased; in postoperative 6m,compare to preoperative the difference was not significant (P>0.05);in postoperative 7d,1m,3m, 6m,the difference among each group was not significant (P>0.05).6.Schirmerâ… test (Schirmerâ… test):In postoperative 7d,1m,the tear secretion decreased,compared with the preoperative,the difference was statistically significant (P<0.05),In postoperative 1m, the the tear secretion gradually increased,in postoperative 6m,compare to preoperative the difference was not significant (P>0.05); in postoperative 7d,1m, 3m, 6m,the difference among each group was not significant (P>0.05).7.tear ferns test(MFT):There was no difference between each group in postoperative 1m,3m,4m and 6m (P>0.05).Compared with the preoperative, there was significant difference (P<0.05)between each group in postoperative 1m,3m,4m,6m. In postoperative 6m;compare to preoperative the difference was not significant (P>0.05).8.conjunctival goblet cells:There was no statistical significance in conjunctival goblet cells(P>0.05) among the groups in postoperative 1m,3m,4m,6m. Compared with the preoperative,there existed statistical significance in conjunctival goblet cells in postoperative among the groups in postoperative 1m,3m,4m,6m(P<0.05).9. Haze: In postoperative 10d ,we conld see Haze ,it got to the peak in postoperative 1m; in postoperative 6m or so it gradually reduced or disappeared. In postoperative 7d,1m,3m,6m the difference among the groups was no significant (P>0.05).Conclusion:1.Flap-free Epi-LASIK combing pranopulin eye drops and tobradex eye drops in preoperative and in postoperative can significantly reduce postoperative pain, promote early recovery of visual acuity.2.Flap-free Epi-LASIK combing pranopulin eye drops and tobradex eye drops in preoperative and in postoperative have a certain influence on corneal epithelial healing, intraocular pressure and Haze.3.The tear film break-up time shorter,tear secretion decreased,the stage of mucus fern test and conjunctival squamous metaplasia deterioted in the early stage in Flap-free Epi-LASIK. In postoperative 6m the tear film break-up time shorter,tear secretion decreased,the stage of mucus fern test recovered to the preoperative level, in postoperative 3m postoperatively conjunctival squamous metaplasia recovered to the preoperative level,early combination of pranopulin eye drops and tobradex eye drops is safe and effective. |
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