白内障超声乳化联合玻璃体注射曲安奈德治疗白内障合并糖尿病性黄斑水肿  

Phacoemulsification combined with intravitreal triamcinolone injection for treatment of patient with cataract and diabetic macular edema

作　　者：侯乒[1] 陈伟奇[1] 李立梅[1] 李太平[1] 

机构地区：[1]汕头大学香港中文大学联合国际眼科中心,汕头515041

出　　处：《中国实用眼科杂志》2009年第4期403-405,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨通过一次性手术在白内障超声乳化联合人工晶状体植入术结束时行玻璃体腔注射曲安奈德（TA），治疗白内障合并糖尿病性黄斑囊样水肿的安全性和有效性。方法对27例32只眼实施白内障超声乳化联合人工晶状体植入及玻璃体腔注射曲安奈德4mg／0．1ml，手术前和手术后1d，7d，1月，3月，6月观察患者的最佳矫正视力（BCVA），眼压，光学相干断层扫描（opticcoherent tomogmphv，OCT）测量黄斑中央凹厚度（central foveal thickness，CFT）的变化。结果32只眼平均LogMarbcva与术前相比均有显著提高（P〈0．05）。手术后1周，1月，3月，6月CFT平均厚度与手术前相比，差别有统计学意义（P〈0．05）。32只眼中有6只眼（18．8％）于术后1月出现暂时性眼压升高，予局部用药后缓解。没有出现视网膜脱离和眼内炎等严重并发症。结论在一次手术中采用白内障超声乳化联合TA治疗伴有糖尿病性黄斑水肿的白内障是安全、有效且合理的。Objective To investigate the safety and efficacy of Phacoemulsification combined with intravitreal triamcinolone injection for treatment of patient with cataract and diabetic macular edema.Methods This study involved 32 eyes of 27 cases.An intravitreal injection of triamcinolone acetonide at the dose of 4 mg/0.1 ml was administered at the end of phacoemulcification and intraocular lens implantation.Best corrected visual acuity, intraocular pressure and central foveal thickness （CFT）measured by optic coherent tomography （OCT）were recorded preoperatively and 1 week, 1 month, 3 months, and 6 months postoperatively.Differences of measurements were evaluated by T-test using SPSS 11.0.Results Mean best-corrected logMAR visual acuity improved significantly from baseline at the 1 week, 1 month, 3 month and 6 month follow-up intervals （P 〈 0.05 ）.The mean central foveal macular thickness,which was obtained 1 week, 1 month, 3 months, 6 months, postoperatively, was significantly different from the baseline measurement （ P 〈 0.05 ）.During the follow-up, six （ 18.8 % ）eyes developed higher intraocular pressure （〉21 mmHg）which was controlled by topical medicine.No severe complications such as retinal detachment or endophthalmitis were fund.Conclusion Phacoemulsification combined with ivTA for treatment of patients with cataract and diabetic macular edema in one operation is a safe, effective and rational approach.

关 键 词：白内障超声乳化 糖尿病视网膜病变 黄斑水肿 曲安奈德 

分 类 号：R587.2[医药卫生—内分泌] R779.66[医药卫生—内科学]