摘要
目的定量检测白内障术后应用妥布霉素地塞米松滴眼液控制术后眼部炎症反应的有效性和安全性。设计前瞻性病例系列。研究对象2013年10月至2014年5月中国医科大学附属第四医院行白内障超声乳化吸除联合折叠式人工晶状体(IOL)植入术的单纯年龄相关性白内障患者238例(284眼)。方法患者行白内障超声乳化吸除联合折叠式IOL植入术,术后予妥布霉素地塞米松滴眼液(典必殊)点眼,于术前、术后1天、1周及1个月对眼压、眼充血(Keratograph角膜地形综合分析仪眼前节图像采集,R-scan软件处理记录结膜充血及睫状充血程度)、房水蛋白浓度(激光闪辉测量仪检测)及SD-OCT黄斑中心凹视网膜厚度检查。主要指标眼压、眼充血、房水蛋白浓度及黄斑中心凹视网膜厚度。结果术后糖皮质激素性高眼压发生率为1.75%(5眼)。术后1周及1个月眼部结膜充血及睫状充血的程度较术后1天明显减轻(χ2=315.35,190.69,P=0.000),且于术后1个月基本接近术前水平。房水蛋白浓度比较,术后1周、1个月分别为(13.3±7.5)、(8.1±5.2)pc/ms,较术后1天(18.2±9.8)pc/ms明显降低(P=0.000)。黄斑中心凹视网膜厚度比较,术后1个月为(254.1±28.4)μm,与术前(249.2±17.8)μm无明显差异。结论通过前瞻性定量检测眼充血、房水蛋白浓度及黄斑中心凹视网膜厚度的结果显示,局部应用妥布霉素地塞米松滴眼液(典必殊)能有效控制白内障术后眼部炎症反应,且具有良好的安全性。
Objective To demonstrate qualitatively the efficacy and safety of tobramycin-dexamethasone eye drops to control ocular inflammation after cataract surgery. Design Prospective case series. Participants 238 age-related cataract patients （284 eyes） undergoing ultrasonic emulsification cataract extraction with intraocular lens implantation. Methods Tobramyein-dexamethasone eye drops （TobraDex ） were instilled for one month postoperatively. Intraoeular pressure, redness analysis with keratography and R-scan software, aqueous flare measurement with Kowa FM600 Laser Flare Meter and foveal retinal thickness with Spectralis OCT were assessed at 1 day preoperatively, 1 day, 1 week and 1 month postoperatively. Main Outcome Measures Intraocular pressure, conjunctival hyperemia and ciliary hyperemia, aqueous flare and foveal retinal thickness. Results 1.75% of a total of 284 eyes reported glucocorticoid-induced ocular hypertension while receiving to bramycin-dexamethasone eye drops postoperatively. Conjunetival hyperemia and ciliary hyperemia were obviously alleviated after local application of tobramycin-dexamethasone eye drops for 1 week and 1 month compared with 1 day postoperatively （X2=315.35, 190.69, P=0.000）, and they were similar to the preoperative level after 1 month. Degree of aqueous flare, 1 week postoperatively was （13.3±7.5） pc/ms, （8.1±5.2） pc/ms after 1 month, is reduced obviously compared with 1 day postoperatively （18.2±9.8） pc/ms （P=0.000）. No significant difference was found in foveal retinal thickness which is （254.1±28.4） μm at I month postoperation and （249.2±17.8） μm preoperatively. Conclusion Through prospective quantitative detection of fovea thickness, ocular hyperemia, and aqueous protein concentration, the results show TobraDex instilled for one month to control and prove post-surgical ocular inflammation after emulsification cataract extraction is safe and effective.
出处
《眼科》
CAS
CSCD
北大核心
2015年第1期51-55,共5页
Ophthalmology in China
关键词
糖皮质激素
超声乳化白内障吸除术
glucocorticoid
ultrasonic emulsification cataract extraction
