非甾体类抗炎药不同给药方式对微切口白内障术后黄斑厚度的影响  

Effects of different doses of non-steroidal anti-inflammatory drugs on changes in macular thickness after micro-incision phacoemulsification

作　　者：王丹丹[1] 冯一帆[1] 廉恒丽[1] 赵云娥[1] 

机构地区：[1]温州医科大学附属眼视光医院杭州院区,杭州310000

出　　处：《中华眼视光学与视觉科学杂志》2015年第8期488-492,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的应用频域光学相干断层扫描仪（OCT）观察非甾体类抗炎药（NSAIDs）不同给药方式对微切口白内障超声乳化吸除术后黄斑区厚度的影响。方法前瞻性随机病例对照研究。将拟行微切口自内障超声乳化手术的患者129例（129眼）按随机数字表法分为甲组（41例），乙组（44例），丙组（44例）。甲组术后不使用任何NSAIDs，乙组术后使用普拉洛芬滴眼液，丙组术后使用普拉洛芬滴眼液联合口服布洛芬缓释胶囊。3组患者均于术后当日开始使用妥布霉素地塞米松滴眼液。分别在术前、术后1d、术后1周、术后6周采用OCT观察患者黄斑区图像特征．应用黄斑地形图分析软件测量黄斑区9个分区视网膜平均厚度。采用单因素方差分析、重复测量方差分析及Pearson相关性分析对数据进行处理。结果3组患者术后BCVA较术前有较大提高，但与黄斑区视网膜厚度的变化不相关。3组患者术后1d时黄斑视网膜厚度差异无统计学意义。3组患者术后1周时黄斑中央区1mm视网膜厚度差异仍无统计学意义，但是A2区丙组增厚较甲组少，差异有统计学意义（P〈0．05）；术后6周时，甲组黄斑CSF厚度明显高于其他2组（P〈0．05）：甲组旁中心凹部分区域较乙组、丙组厚，差异有统计学意义。结论NSAIDs的应用可以减轻微切口白内障超声乳化术后黄斑区视网膜厚度的增加，口服NSAIDs在早期一定程度上减轻了黄斑旁中心凹区视网膜的增厚。Objective To compare the effects of different delivery methods of non-steroidal anti-inflammatory drugs （NSAIDs） on changes in maeular thickness after uncomplicated micro-incision phacoemulsification using spectral domain optical coherence tomography （OCT）. Methods In this prospective study, 129 patients were randomly divided into three groups. After surgery, group A （41 cases） received no NSAIDs, group B （44 cases） received pranoprofen and group C （44 cases） received pranoprofen combined with ibuprofen （sustained-release capsules）. All patients were treated with topical tobramycin and dexamethasone postoperatively. OCT measurements were performed preoperatively and at 1 day, 1 week and 6 weeks postoperatively. The mean macnlar thicknesses of 9 sectors were analyzed with the macular thickness mapping protocol of the OCT. Data were analyzed using one-way ANOVA, repeate measured ANOVA, and Pearson correlation analysis. Results Compared with preoperative acuity, there was a significant increase in best corrected visual acuity （BCVA） after surgery in all 3 groups. However, there was no correlation between changes in macular thickness and BCVA. At 1 day after surgery, no significant differences in retinal thickness were found among the 3 groups. At 1 week after surgery, the 1-ram central subfield （CSF） thickness showed no significant difference among the groups. However, there was a significant difference in the retinal thickness of the parafoveal area （A2） between groups A and C （P〈0.05）. Furthermore, the thicknesses of the CSF and some parafoveal areas in group A were significantly greater than those in groups B and C （P〈0.05）. Conclusion NSAIDs may have some effects on alleviating macular thickening after surgery. To some extent, oral NSAIDs are effective during the early stage after surgery.

关 键 词：非甾体类抗炎药 黄斑厚度 黄斑囊样水肿 白内障微切口超声乳化手术 体层摄影术 光学相干 

分 类 号：R779.6[医药卫生—眼科]