Clinical
Trials
of Denas Therapy
after Lasik
surgeries
Coach
Jimmy K presents................
Korotkikh
S.A., Korotkikh V.S., Petrov S.V.
Ural
State Medical Academy,
NPC
"Ophthalmology", Yekaterinburg, Russia
Influence
of dynamic electrotimulation (DENAS) on engraftment of the corneal
flap after excimer-laser surgeries (after lasik surgeries),
possibilities of increasing functional results and reducing
rehabilitation periods was studied in 30 patients as well as DENAS
influence on ophthalmo-ergonomic indexes which influence visual
efficiency in the post-operative period. The results are the evidence
that DENAS applied after lasik surgeries have a joint
multi-component effect: have a pronounced analgetic and anti-edema
effect, results in acceleration of engraftment of the corneal
epithelial flap, promotes more qualitative regeneration of the
cornea, improvement and faster restoration of visual functions,
provides for increasing and faster stabilization of the refractive
effect, increase of its forecast accuracy.
Nowadays
excimer-laser surgery (lasik surgery) is a basis for
refractive operations for myopia correction. The basic methods are
LASEK (EPI-LASIK) and LASIK (INTRA-LASIK). Any surgical methods have
their certain disadvantages. These include pain syndrome in the early
postoperative period, defective engraftment of the corneal flap as
well as prolonged restoration of visual functions which influence
visual capacity. In the scientific literature a great attention is
given to the issue of corneal flap engraftment after eye surgeries
[5, 9].
A
relation between the speed and nature of corneal epithelial
flap engraftment and degree of its transparency in the future was
discovered, which in its turn influence the refractive result of the
surgical operation carried out [2, 3]. Assessment of professional
capabilities of the organ of vision in patients after refractive
operations is also of great interest. A number of authors note that
some functions such as low-contrast visual acuity, spatial contrast
sensitivity, blinding sensitivity are restored after surgeries within
the periods up to 6 months. "Dry eye syndrome" occurring
transiently and some other complications are the biggest problem of
modern refractive surgery. Bulk of practical investigations is
connected with drug therapy of these complications.
Along
with the above, electro stimulation is known to be applied in
ophthalmology for therapy of different pathologic processes [1, 4, 6,
8, 10]. A positive influence of electro stimulation for resolving
many problems can be noted.
The
purpose of the present research is to study influence of dynamic
electroneurostimulation on engraftment of the corneal flap after
eye surgeries in compliance with LASEK technology and possibility
of improving functional results as well as reduction of terms of
visual functions restoration which is especially important in
professions making raised demands of the visual analyzer.
Materials
and methods. healing set consisting of transcutaneous
electrostimulator "DENAS" and external paraorbital
electrode DENS
Glasseswere applied for the research. DENAS results after refractive
surgeries for myopia
were
studied in 30 patients (60 eyes) -15 men (50.0 %) and 15 women (50.0
%) in the 23-47 years (on average 30.4±0.8 years). Myopia
degree
varied from -5.0 to -16.0 dptr, average value -9.79±0.25 dptr.
Patients in the main and control groups were selected as to have
approximately equal degree of myopia,
corneametric
data and extent of operation. For research excimer laser MEL-60
(Germany) was used.
DENAStherapy was carried out starting from the 1st day after the eye
surgery. therapy was applied in the paraorbital zone in the MED
program, and then in the "THERAPY" mode at frequency 77 Hz
during 10 minutes; in the cervical-collar zone -in the "TEST"
mode, with therapy of found latent trigger zones in the "THERAPY"
mode at frequency 77 Hz -3-5 minutes for each zone. Each patient had
12-14 procedures.
For
assessment of the results in the main and control groups, the
following tests were carried out:
-
check of visual acuity with correction;
-
check of low-contrast visual acuity with help of the projector of
test signs
Carl
Zeiss Jena at 18 % contrast;
-
reserve of relative accommodation;
-
terms and quality of corneal flap engraftment and subjective
sensations.
Results
and discussion. All patients in the main group had a pronounced
analgesic effect registered intensity of the sensation of pain was
lower and pain relieved earlier than in the control group.
No
intolerance of procedures, allergic reactions were registered in the
main group. A special attention was paid to the manifestation degree
of the postoperative reaction. Degree of corneal syndrome in the main
group was less and corneal epithelial flap engraftment was faster.
Two
variants of corneal epithelial flap engraftment were discovered:
favorable - full engraftment and unfavorable - a small edge defect of
the flap with edematic edges and areas of loose flexible engraftment.
A
favorable variant of cornea epithetization was registered (100 %
of cases) in all eyes in the main group which had DENAS.
In
the control group, which did not use DENAS, favorable variant was
registered in 47 (78.3 of cases). In 13 eyes (21.7%) an unfavorable
variant of corneal epithelial flap engraftment was registered,
which was accompanied by the corneal syndrome. A direct relation
between an edema degree of the corneal epithelium and nature of its
healing was registered: the more the edema - the worse the healing.
For
more information about DENAS
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