普拉洛芬对糖尿病患者白内障术后黄斑中心凹厚度以及视力的影响  

Impact of Pranoprofen on macular thickness and visual acuity after cataract surgery in diabetic mellitus patients

作　　者：陈月芹[1] 石尧[1] 薛春燕[1] 陈银[1] 朱婷[1] 叶芬[1] 胡钦瑞[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)眼科,南京医学硕士研究生210002

出　　处：《医学研究生学报》2011年第10期54-56,共3页Journal of Medical Postgraduates

基　　金：南京军区医药卫生科研基金(07M086)

摘　　要：目的白内障超声乳化术后发生黄斑囊样水肿(cystoid macular edema,CME)是引起视力下降的主要原因,局部应用非类固醇抗炎药(non-steroidal anti-inflammatory drugs,NSAID)可以有助于促进术后视力的恢复。文中评估糖尿病患者局部使用普拉洛芬对白内障超声乳化术后黄斑中心凹厚度以及视力的影响。方法将合并有糖尿病的行白内障超声乳化手术的120眼随机分为2组,每组60眼。实验组:普拉洛芬联合复方妥布霉素眼液局部点眼;对照组:局部应用复方妥布霉素眼液。术前以及术后4周测量黄斑中心凹厚度以及视力。结果术后实验组、对照组的裸眼视力(uncorrected visual acuity,UCVA)以及最佳矫正视力(best corrected visual acuity,BCVA)较术前均有明显提高(P<0.01)。术后4周实验组以及对照组黄斑中心凹厚度均有所增加(P<0.01),实验组术后黄斑中心凹厚度低于对照组(P=0.003),实验组术后黄斑囊样水肿的发生率低于对照组(P=0.036)。术后黄斑中心凹的增加量与BCVA(LogMAR)呈正相关(r=0.747,P<0.01)。结论糖尿病患者白内障超声乳化术前及术后局部应用普拉洛芬能够预防术后CME的发生,并可能有助于恢复良好的视力。Objective Cystoid macular edema(CME) is thought to be the main cause of decreased visual acuity after phacoemulsification and it is suggested that topical NSAID should be uesd to promote the recovery of visual acuity.This study is to evaluate the effect of topical Pranoprofen using after routine cataract phacoemulsification surgery in diabetic mellitus(DM) patients on macular thickness and its effect on visual acuity.Methods One hundred and twenty eyes with DM had uneventful cataract phacoemulsification surgery.The eyes were randomized to topical treatment with Tobramycin and Dexamethasone combined with Pranoprofen(treatment group,60 eyes) or Tobramycine and Dexamethasone(control group,60 eyes).Macular thickness using optical coherence tomography(OCT) measurement and visual acuity were measured preoperatively and 4weeks postoperatively.Results Uncorrected visual acuity(UCVA) and best corrected visual acuity(BCVA) were improved significantly after surgery in both the contorl(P<0.001) and the reatment(P<0.001) groups.There were increment in macular thickness in both the control(P<0.001) and the treatment(P<0.001) groups 4 weeks after surgery,and the increment of macular thickness in the treatment group was lower than that in the control group(P=0.003).The occurrence of cystoid macular edema(CME) was lower in the treatment group than that in the control group(P=0.036).And the increment in the macular thickness showed a positive correlation with BCVA(LohMAR) after surgury(r=0.747,P<0.001).Concusion The topical use of Pranoprofen before and after cataract phacoemulsification surgery in DM patients could prevent the occurrence of CME and may be necessary to achieve excellent visual acuity.

关 键 词：白内障 超声乳化 糖尿病 黄斑中心凹厚度 黄斑囊样水肿 非类固醇类抗炎药 

分 类 号：R58[医药卫生—内分泌]