Wang Jin-Jin, Yu Ao-Miao, Liu Chang, Huang Yue, Yang Rui-Bo, Zhang Chen, Liu Hui, Zhao Shao-Zhen
Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China.
Int J Ophthalmol. 2025 Jun 18;18(6):996-1002. doi: 10.18240/ijo.2025.06.04. eCollection 2025.
To compare the efficacy of 3% diquafosol sodium (DQS) eye drops at different frequencies in dry eye (DE) after femtosecond laser-assisted keratomileusis (FS-LASIK).
In this prospective study, DE patients after FS-LASIK were randomly divided into two groups. All patients were administered routine anti-inflammatory and anti-infective drugs after FS-LASIK. Additionally, both groups were treated with DQS, at frequencies of 4 (DQS4 group) and 6 (DQS6 group) times daily. Corneal fluorescein staining (CFS) score, non-invasive tear breakup time (NIBUT), tear meniscus height (TMH), lipid layer thickness (LLT), and incomplete blink rate (IBR) were assessed in patients preoperatively and at 1wk, 1, and 3mo postoperatively. The Ocular Surface Disease Index (OSDI) questionnaire was also administered.
Totally 119 patients (238 eyes) were randomly divided into the DQS4 group (60 individuals with 120 eyes) and DQS6 group (59 individuals with 118 eyes). From 1wk to 1mo after FS-LASIK, the CFS score in the DQS6 group decreased with statistical significance (=0.014), while the DQS4 group showed an upward trend. Comparing with preoperative values, the NIBUT of both groups was significantly prolonged at various time points after FS-LASIK (<0.05). Within 1mo post FS-LASIK, both groups had significantly higher OSDI scores compared with preoperative values (<0.05). At postoperative 3mo, the DQS4 group recovered to a level similar to that before surgery (>0.05), while the DQS6 group remained a little higher than preoperative values (>0.05). The TMH levels in the DQS4 group increased significantly at 1wk postoperatively (<0.05), while there was no statistically significant change in the TMH levels in the DQS6 group (>0.05). There was no significant difference in IBR and LLT between the two groups within 1mo postoperatively. At postoperative 3mo, the LLT in the DQS4 group was significantly higher than that in the DQS6 group (<0.05).
Within 1mo post-FS-LASIK, applying DQS six times daily is superior to four daily applications in improving CFS score, and in increasing NIBUT meanwhile. After 1mo, applying DQS four times daily also effectively alleviate DE symptoms and improve DE signs. Therefore, we recommend DE patients using DQS eye drops 6 times daily within 1mo after FS-LASIK, and maintaining it 4 times daily until 3mo postoperatively.
比较飞秒激光制瓣准分子原位角膜磨镶术(FS-LASIK)后不同频次使用3%双醋瑞因钠(DQS)滴眼液治疗干眼(DE)的疗效。
在这项前瞻性研究中,将FS-LASIK术后的DE患者随机分为两组。所有患者在FS-LASIK术后均给予常规抗炎和抗感染药物。此外,两组均使用DQS治疗,每日频次分别为4次(DQS4组)和6次(DQS6组)。在患者术前以及术后1周、1个月和3个月时评估角膜荧光素染色(CFS)评分、非侵入性泪膜破裂时间(NIBUT)、泪河高度(TMH)、脂质层厚度(LLT)和不完全眨眼率(IBR)。同时还进行眼表疾病指数(OSDI)问卷调查。
总共119例患者(238只眼)被随机分为DQS4组(60例,120只眼)和DQS6组(59例,118只眼)。FS-LASIK术后1周至1个月,DQS6组的CFS评分下降有统计学意义(P=0.014),而DQS4组呈上升趋势。与术前值相比,两组在FS-LASIK术后各时间点的NIBUT均显著延长(P<0.05)。FS-LASIK术后1个月内,两组的OSDI评分均显著高于术前值(P<0.05)。术后3个月时,DQS4组恢复到与术前相似的水平(P>0.05),而DQS6组仍略高于术前值(P>0.05)。DQS4组的TMH水平在术后1周时显著升高(P<0.05),而DQS6组的TMH水平无统计学显著变化(P>0.05)。术后1个月内两组的IBR和LLT无显著差异。术后3个月时,DQS4组的LLT显著高于DQS6组(P<0.05)。
FS-LASIK术后1个月内,每日使用6次DQS在改善CFS评分及同时增加NIBUT方面优于每日使用4次。1个月后,每日使用4次DQS也能有效缓解DE症状并改善DE体征。因此,我们建议DE患者在FS-LASIK术后1个月内每日使用DQS滴眼液6次,并持续至术后3个月每日使用4次。