他克莫司与环孢素A对角膜移植术后泪河高度影响的对比研究
Tacrolimus and Cyclosporine A after Keratoplasty Comparative Study on the Influence of the Tear Meniscus Height
DOI: 10.12677/HJO.2022.113031, PDF,    科研立项经费支持
作者: 杨琪瑶, 李 兰*, 曹 倩, 李云川, 李 勇, 董 洁：昆明市第一人民医院甘美医院眼科，云南 昆明
关键词: 角膜移植；他克莫司滴眼液；环孢素A滴眼液；泪河高度；Keratoplasty； Tacrolimus Eye Drops； Cyclosporin A Eye Drops； Tear Meniscus Height
摘要: 目的：探讨角膜移植术后使用他克莫司滴眼液和环孢素A滴眼液抗排斥对患眼泪河高度的影响。方法：选取38例(38眼)穿透性角膜移植术的患者为研究对象，术后分别使用他克莫司滴眼液和环孢素A滴眼液，并进行泪河高度测定。结果：角膜移植术后6月使用他克莫司与环孢素A抗排斥，对泪河高度的影响差异无统计学意义(P > 0.05)；环孢素A组患者泪河高度术后6月较术前的差异有统计学意义，P = 0.012 (P < 0.05)；他克莫司组患者不同时期泪河高度差异均无统计学意义，P > 0.05；术后使用他克莫司滴眼液的患者泪河高度趋于稳定，而使用环孢素A滴眼液的患者术后泪河高度呈下降趋势。结论：他克莫司滴眼液比环孢素A滴眼液对角膜移植术后泪河高度的影响更小，更有利于眼表环境趋于稳定。
Abstract: Objective: To investigate the influence of tacrolimus eye drops and cyclosporin A eye drops on the tear meniscus height in patients with anti-rejection after keratoplasty. Methods: 38 patients (38 eyes) who underwent penetrating keratoplasty were selected as the research objects. They were treated with tacrolimus eye drops and cyclosporin A eye drops to resist rejection, and the tear meniscus height was measured. Results: 6 months after keratoplasty, tacrolimus and cyclosporine A had no significant effect on the height of the tear meniscus height (P > 0.05). The tear meniscus height of cyclosporine A group was statistically significant 6 months after surgery compared with that before surgery, P = 0.012 (P < 0.05). There was no significant difference in tear meniscus height in tacrolimus group at different periods, P > 0.05; the tear meniscus height tended to be stable in patients who received tacrolimus eye drops after surgery, while decreased in patients who received cyclosporine A eye drops. Conclusion: Compared with cyclosporine A eye drops, tacrolimus eye drops have a smaller effect on the tear meniscus height after keratoplasty, and it is easier to stabilize the ocular surface environment.
文章引用：杨琪瑶, 李兰, 曹倩, 李云川, 李勇, 董洁. 他克莫司与环孢素A对角膜移植术后泪河高度影响的对比研究[J]. 眼科学, 2022, 11(3): 222-227. https://doi.org/10.12677/HJO.2022.113031

参考文献

[1] 史伟云, 高华. 中国角膜病诊疗技术70年发展回顾[J]. 中华眼科杂志, 2020, 56(6): 401-408.
[2] Li, S., Li, L., Zhou, Q., et al. (2019) Blood Vessels and Lymphatic Vessels in the Cornea and Iris after Penetrating Keratoplasty. Cornea, 38, 742-747.
[Google Scholar] [CrossRef] 
[3] 李旭, 张樱楠, 尹明阳, 等. 0.1%他克莫司滴眼液防治高危角膜移植术后免疫排斥反应的临床观察[J]. 中华眼科杂志, 2019, 55(6): 419-427.
[4] 于立新, 姚冰, 杜传福, 等. 肾移植术后他克莫司替换环孢素A的临床观察[J]. 中华泌尿外科杂志, 2003, 24(3): 169-171.
[5] 中华医学会眼科学分会角膜病学组. 我国角膜移植手术用药专家共识(2016年) [J]. 中华眼科杂志, 2016, 52(10): 733-737.
[6] 王春筱, 刘奕志, 袁进, 等. 眼前节相干光断层扫描测量下方泪河高度及其在干眼症诊断中的应用[J]. 中华眼科杂志, 2009, 45(7): 616-620.
[7] Lin, X., Xu, B., Sun, Y., et al. (2014) Comparison of Deep Anterior Lamellar Keratoplasty and Penetrating Keratoplasty with Respect to Postoperative Corneal Sensitivity and Tear Film Function. Graefe’s Archive for Clinical and Experimental Ophthalmology, 252, 1779-1787.
[Google Scholar] [CrossRef] [PubMed]
[8] 孔令宇, 李兰. 泪膜破裂时间与角膜移植术后上皮修复的相关性分析[J]. 云南医药, 2018(3): 211-213.
[9] Arto, U. (2006) Challenges and Obstacles of Ocular Pharmacokinetics and Drug Delivery. Advanced Drug Delivery Reviews, 58, 113-115.
[Google Scholar] [CrossRef] [PubMed]
[10] Wilson, S.L., Ahearne, M. and Hopkinson, A. (2015) An Overview of Current Techniques for Ocular Toxicity Testing. Toxicology, 327, 32-46.
[Google Scholar] [CrossRef] [PubMed]
[11] Armitage, W., Goodchild, C., Griffin, M., et al. (2019) High-Risk Corneal Transplantation: Recent Developments and Future Possibilities. Transplantation, 103, 2468-2478.
[Google Scholar] [CrossRef] 
[12] Luaces-Rodríguez, A., et al. (2018) Preclinical Characterization and Clinical Evaluation of Tacrolimus Eye Drops. European Journal of Pharmaceutical Sciences, 120, 152-161.
[Google Scholar] [CrossRef] [PubMed]
[13] Shin, H.C., et al. (2019) Pharmacokinetic Study of 3-in-1 Poly(ethylene glycol)-block-poly(D, L-lactic acid) Micelles Carrying Paclitaxel, 17-Allylamino-17-Demethoxygeldanamycin, and Rapamycin. Journal of Controlled Release, 163, 93-99.
[Google Scholar] [CrossRef] [PubMed]
[14] 廖雪梅, 冯晓, 上官国涵. 他克莫司滴眼液对高危角膜移植术后免疫排斥反应的影响观察[J]. 中国药师, 2020, 23(3): 481-484.
[15] Reza, G., Hamed, G., Mehran, Z., et al. (2017) Tacrolimus Eye Drops as Adjunct Therapy in Severe Corneal Endothelial Rejection Refractory to Corticosteroids. Cornea, 36, 1195-1199.
[Google Scholar] [CrossRef] 
[16] 许红昌, 马悦, 黄丽颖, 等. 角膜移植术后干眼的研究进展[J]. 国际眼科杂志, 2021, 21(2): 253-256.

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