非甾体类抗炎药给药时间对飞秒激光辅助白内障乳化吸除术中瞳孔缩小的影响  

Effect of application times of nonsteroidal anti-inflammatory drugs on miosis in femtosecond laser-assisted cataract surgery

作　　者：朱海芹 蔡俊杰 陈聪 陈靖 Zhu Haiqin;Cai Junjie;Chen Cong;Chen Jing(Operation Center,Eye Hospital Affiliated to Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属眼视光医院手术中心,浙江温州325027

出　　处：《中国药物与临床》2023年第4期220-224,共5页Chinese Remedies & Clinics

基　　金：浙江省温州市基础性医疗卫生科技项目(Y20190344)。

摘　　要：目的分析非甾体类抗炎药(NSAIDs)不同给药时间对飞秒激光辅助白内障乳化吸除术(FLACS)手术瞳孔缩小的影响。方法FLACS的111例患者111只眼纳入研究,根据术前使用NSAIDs情况分为对照组(未使用NSAIDs)23例、治疗A组(术前<1 d使用NSAIDs)44例、治疗B组(术前≥3 d使用NSAIDs)44例。采用手术录像系统结合Digimizer软件,记录测量激光操作前后及超声乳化手术划刀前瞳孔直径。结果激光前瞳孔对照组为(7.0±0.6)mm、治疗A组为(7.0±0.6)mm、治疗B组为(7.0±0.7)mm,差异无统计学意义(P=0.874);划刀前瞳孔对照组为(5.2±1.3)mm、治疗A组为(6.3±0.8)mm、治疗B组为(6.7±0.7)mm,差异有统计学意义(P<0.01);划刀前瞳孔对照组14例(61%)、治疗A组11例(25%)、治疗B组4例(9%)出现瞳孔直径<6 mm,差异有统计学意义(χ^(2)=21.030,P<0.01)。Logistic回归分析结果显示术前使用NSAIDs可降低瞳孔缩小至6 mm的发生概率(OR=0.214,P=0.005;OR=0.064,P<0.01)。结论术前不同时期联合NSAIDs均可以有效预防FLACS术中瞳孔缩小的发生率,但术前≥3 d使用NSAIDs的用药方案对维持瞳孔大小更具有优越性。Objective To analyze the effect of different dosing times of nonsteroidal anti-inflammatory drugs(NSAIDs)on miosis in femtosecond laser-assisted cataract surgery(FLACS).Methods One hundred and eleven eyes of 111 patients with FLACS were enrolled in the study and divided into 23 cases in the control group(without NSAIDs prior to surgery),44 cases in group A(NSAIDs within 1 day of surgery),44 cases in group B(NSAIDs≥3 days prior to surgery)according to preoperative use of NSAIDs.The pupil diameters were measured by surgical video system combined with Digimizer software before and after FLACS and before the incision of surgery.Results The prelaser pupil was(7.0+0.6)mm in the control group,(7.0+0.6)mm in treatment group A,and(7.0+0.7)mm in treatment group B.The dfference was not statistically significant(P-0.874);the pre-scratch pupil was(5.2±1.3)mm in control group,(6.3±0.8)mm in group A and(6.7±0.7)in group B,the difference was statistically significant(P<0.01).Before phacoemulsification,14(61%)patients in the control group,11(25%)patients in the group A,4(9%)patients in the group B had pupil diameters less than 6 mm(χ^(2)=21.030,P<0.01).Logistic regression analysis showed that preoperative use of NSAIDs reduced the incidence of pupil diameter reduction to 6 mm.Conclusion Combining NSAIDs at different periods before operation can effectively prevent the inci-dence of miosis during FLACS,but the medication regimen of using NSAIDs≥3 days before operation was more advantageous for maintaining pupil size.

关 键 词：消炎药 非甾类 飞秒激光辅助白内障乳化吸除 瞳孔缩小 

分 类 号：R779.6[医药卫生—眼科]