自体血清滴眼液联合醋酸泼尼松龙治疗重度干眼合并Ⅱ-Ⅲ级角膜损伤的短期疗效观察OA

AIM:To investigate the short-term efficacy of autologous serum eye drops combined with prednisolone acetate in the treatment of severe dry eye with grade Ⅱ-Ⅲ corneal injury. METHODS:Prospective,randomized,controlled single center study.Totally 122 patients(122 eyes,all enrolled patients had bilateral disease,with the more severely affected eye selected as the study eye;if the severity was similar between both eyes,the right eye was chosen as the study eye)with severe dry eye and grade Ⅱ-Ⅲ corneal injury who were treated at Wuhan University Affiliated Aier Eye Hospital from March 2023 to March 2025 were randomly divided into a control group(treated with sodium hyaluronate eye drops combined with autologous serum eye drops)and an observation group(treated with sodium hyaluronate eye drops,autologous serum eye drops combined with prednisolone acetate eye drops)using a random number table method.After continuous administration for 2 wk,the tear inflammatory reaction[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],subjective symptoms[ocular surface disease index(OSDI)score],lacrimal gland function[tear film break-up time(TBUT)and Schirmer tear secretion test(SⅠt)],corneal injury degree[corneal fluorescein staining(CFS)score]and corneal nerve function[total number and density of corneal subepithelial nerve(SBN)]before and after treatment were compared between the two groups,and the occurrence of adverse reactions during treatment was recorded. RESULTS:All patients have completed follow-up.The control group consisted of 61 cases and 61 eyes,with 24 males and 37 females,with an average age of 43.87±5.12y.There were 61 cases and 61 eyes in the observation group,including 21 males and 40 females,with an average age of 42.15±4.76y.At 1 and 2 wk after treatment,the levels of IL-6 and TNF-α in tears,OSDI score,and CFS score of the two groups were significantly lower than those before treatment,and those in the observation group were lower than those in the control group(all P<0.05).The total number of TBUT,SⅠt,SBN,and SBN density in both groups of patients increased significantly compared to before treatment,and the observation group was higher than the control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups of patients during treatment(P=0.717). CONCLUSION:The combination of autologous serum eye drops and prednisolone acetate is effective in treating severe dry eye with grade Ⅱ-Ⅲ corneal injury.It can reduce patients'inflammatory reactions,subjective symptoms,and degree of corneal injury,promote the improvement of lacrimal gland function and corneal nerve function,providing a new strategy for corneal nerve repair.Furthermore,the combination therapy does not increase the risk of adverse reactions and shows good safety in short-term application.