·临床研究·神经生长因子滴眼液对LASIK术后角膜瓣神经修复的影响朱丹丹陈辉EffectofNGFeyedroponhumancentralcornealnerveregenerationafterlaserinsitukeratomileusisZhuDandan,ChenHui.DepartmentofOphthalmology,AffiliatedHospital,NantongUniversity,Nantong226001,ChinaAbstractObjectiveManystudiesshowedagoodeffectivenessofnervegrowthfactor(NGF)ontherecoveryofcornealsensitivityfollowingthelaserinsitukeratomileusis(LASIK).However,nostudyreportverifiedtheregenerationofcornealnervefiberinthemorphology.ThisstudywastodetermineiftopicallyadministrationofNGFplaysaroleinacceleratingthereinnervationofcentralcornealflapnerveafterLASIK.MethodsAprospectivedouble2maskedrandomizedstudywasdesigned.TheLASIKwasperformedin70eyesfrom30patientsaged18-40yearswiththeequivalentlens-3100--6100D.NGFwastopicallyutilizedin36eyesafterLASIKastrailgroup,andanequalamountofbalancedsalinesolutionwasusedintheother34eyesfromageandgender2matchedpatientsatthesamewayincontrolgroup.Thecornealsensation,tearfilmbreak2uptime,tearcontentwereexaminedin10days,1,3and6monthsafterLASIK,andcornealnervefiberdensitywascountedwithconfocalscanninglaserophthalmoscopy(HeidelbergRetinaTomographⅡRostockCorneaModuleRostockSystem).TheHumanResearchEthicsCommitteeofthishospitalapprovedthestudyprotocol.ResultsAllthepatientscompletedthetreatingandfollowing2upprocedureaccordingtothetrialprotocolandwereincludedtotheintention2to2treatanalysis.Nosignificantdifferencewasfoundinthecomparisonofgeneraldataandclinicalcharacteristicsbetweentwogroups(P>0105).Thecornealsensationwaslowerinthe10thdayafterLASIKthanbeforeLASIKandgraduallyrecoveredafterthattimeinbothgroups.TheBUTaftersurgerywassignificantlyshorterthanbeforeLASIK(P<0105)andreturnedtobaselinelevelafter6months.Nervefibersinsuperficialstromainthehingeofcornealflapwerenotdamaged,however,superficialstromalnervefibersinthecentralcornealflapwereabsentafterLASIK.Lessregeneratingnervefiberswerevisualizedincornealstromawithin1monthafterLASIK.Newnervefibersfromdeepstromaformednetsandapproachedtheshallowstromaat3months.ThenumberofnewfibersinthecentralcornealflapinNGFgroupwasmorethanthatofcontrolgroupinthe6thmonth(t=51798,P=01000).ConclusionThisstudysuggeststhattopicalapplicationofNGFmayenhancecentralcornealnerveregenerationafterLASIK.Keywordslaserinsitukeratomileusis;nerveregeneration;nervegrowthfactor摘要目的观察准分子激光原位角膜磨镶术(LASIK)术后不同时期中央角膜神经的再生情况及神经生长因子(NGF)滴眼液对神经再生的影响。方法采用随机双盲前瞻性对照研究,将35例(70眼)行LASIK的青壮年近视患者随机分为NGF组和对照组,分别检查术前、术后10d、1、3、6个月角膜知觉、泪膜破裂时间(BUT)、泪液分泌量及中央角膜神经密度并进行比较。结果术后10d、1、3、6个月角膜知觉、BUT、泪液分泌量2组间差异均无统计学意义(P>0105)。术后3个月内角膜神经密度2组间差异无统计学意义(P>0105),术后6个月NGF组神经密度高于对照组,2组间差异有统计学意义(P<0105)。结论NGF滴眼液对LAISK术后角膜神经修复有促进作用。关键词准分子激光原位角膜磨镶术;神经再生;神经生长因子分类号R779163文献标识码A文章编号100320808(2009)0520420205作者单位:226001南通大学附属医院眼科(朱丹丹,硕士研究生,现在南京市鼓楼医院宁益眼科中心210008)通讯作者:陈辉(Email:chenhuieye@1261com)准分子激光原位角膜磨镶术(laserinsitukeratomileusis,LASIK)术后部分患者有异物感等不适。研究发现这些症状体征的出现与术中在切开角膜瓣、·024·ChinOphthalRes,May2009,Vol.27,No.5切削角膜基质的同时,不同程度地损伤了角膜神经有关[1-4]。如...
