摘要
目的:比较白内障超声乳化吸除术后单纯用典必殊滴眼液(地塞米松+妥布霉素)和典必殊滴眼液减量使用加普南普灵(普拉洛芬)滴眼液预防黄斑囊样水肿的发生,以探讨激素和非甾体类抗炎药联合使用在白内障术后预防黄斑囊样水肿的临床价值。方法:采用随机对照的方法,从2007-01/2007-10将术中无并发症的220眼分为两组,每组110眼。试验组:典必殊滴眼液加普南普灵滴眼液合用2wk后普南普灵滴眼液单独使用2wk;对照组:典必殊滴眼液使用4wk。在术后不同时间观察随访患者的症状、体征,并测量眼压,散瞳检查眼底以及应用光学相干断层扫描仪分析(optical coherence tomography,OCT)。结果:两组的术后症状和体征无显著性差异(P>0.05);房水闪辉术后1wk无显著性差异(P>0.05),从术后第2wk开始到4wk均有显著性差异(P<0.05),试验组比对照组闪光值低;在术后2wk和1mo时,对照组的眼压比术前有所增加,而试验组则轻微降低,且有显著性差异(P<0.05),在术前、术后3mo时两组均行OCT检查,对照组与试验组术后黄斑囊样水肿(cystoids macular edema,CME)的发生率不同并且有显著性差异(P<0.05)。结论:无并发症的白内障超声乳化吸除术后应用激素加非甾体类抗炎药滴眼液比单纯激素滴眼液抗炎对白内障术后黄斑囊样水肿有显著的预防作用。
AIM： To compare the occurrence of cystoids macular edema （CME） after phacoemulsification and intraocular lens （IOL） implantation using postoperative treatment with steroids or steroids combined with NSAID.
METHODS： A prospective, randomized, controlled study including 220 patients, from Jan. 2007 to Oct. 2007, enrolled for cataract surgery. After uneventful phacoemulsification and IOL implantation, the patients were randomized to topical treatment with Tobramycin and Dexamethasone combined with Pranoprofen （trial group, 110 eyes） or Tobramycin and Dexamethasone control group, 110 eyes ）. The sign, symptom, intraocular pressure （ lOP ） and optical coherence tomography （OCT） were determined at 2 and 4 weeks postoperatively.
RESULTS： There were no significant differences in symptoms and signs between two groups （P 〉 0. 05）. There were no significant differences of aqueous flare was observed between two groups after 1 week （ P〉 0.05）. A decrease of aqueous flare was observed in trial group after 2 and 4 weeks （ P 〈 0.05）. An increase of lOP was observed in control group after 2 weeks and 1 month, while a decrease was observed in trial group （ P 〈 0.05）. After 3 months, the occurrence of CME was lower in trial group than that in control （P〈0.05）.
CONCLUSION. After uneventful phacoe.mulsification and IOL implantation, using Dexamethasone with Pranoprofen has excellent effect and is better than only using Dexamethasone on prophylaxis of CME.
出处
《国际眼科杂志》
CAS
2008年第7期1370-1372,共3页
International Eye Science
