地塞米松玻璃体内植入剂治疗玻璃体切除硅油填充术后黄斑水肿的短期观察  

Short-term observation on dexamethasone intravitreal implant in the treatment of macular edema after vitrectomy and silicone oil tamponade

作　　者：胡汝平 王伟献 杨顺 陈雅 田磊 Hu Ruping;Wang Weixian;Yang Shun;Chen Ya;Tian Lei(Department of Ophthalmology,the Municipal First People’s Hospital of Zhumadian,Zhumadian 463000,China)

机构地区：[1]驻马店市第一人民医院眼科,驻马店463000

出　　处：《中华眼外伤职业眼病杂志》2023年第12期938-942,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察地塞米松玻璃体内植入剂在治疗玻璃体切除及硅油填充术后黄斑水肿的短期效果。方法回顾性病例系列研究。收集驻马店市第一人民医院眼科2021年1月至2023年5月玻璃体切除及硅油填充术后黄斑水肿进行地塞米松玻璃体内植入剂治疗的23例(23眼)的临床资料。随访3个月,观察治疗前后的最佳矫正视力(BCVA,logMAR)、眼压和黄斑中心区厚度(CMT)等指标。结果随访至期末,治疗后1、2及3个月,BCVA分别为0.65±0.20,0.58±0.12,0.45±0.15,均较治疗前(0.80±0.35)提高(t=2.16、3.31、4.21,均P<0.05)。治疗后1、2及3个月CMT分别为(340.83±85.62)、(280.47±70.41)、(240.10±40.83)μm,均较治疗前(490.56±100.23)μm下降(t=5.13、5.53、5.61,均P<0.05)。随访期间,有3例眼压升高,给予1种降眼压药后降低至正常。未观察到眼部及全身的其他不良反应。结论地塞米松玻璃体内植入剂在短期内能有效改善玻璃体切除及硅油填充术后的黄斑水肿,提高视力。Objective To observe the short-term efficacy of dexamethasone intravitreal implant in the treatment of macular edema after vitrectomy with silicone oil tamponade.Methods This was a retrospective case series study.The clinical data of 23 eyes of 23 cases with macular edema after vitrectomy with silicone oil tamponade from Jan.2021 to May 2023 in the First People’s Hospital of Zhumadian were collected,and dexamethasone intravitreal implant was given.The patients were followed up for 3 months.The best corrected visual acuity(BCVA,logMAR),intraocular pressure and central macular thickness(CMT)were observed before and after treatment.Results BCVA was 0.65±0.20,0.58±0.12,0.45±0.15 at 1,2 and 3 months after treatment,respectively,which were significantly higher than those before treatment(0.80±0.35)(t=2.16,3.31,4.21;all P<0.05).The CMT was(340.83±85.62),(280.47±70.41),(240.10±40.83)μm at 1,2 and 3 months after treatment,respectively,which were significantly lower than those before treatment(490.56±100.23)μm(t=5.13,5.53,5.61;all P<0.05).During the follow-up,intraocular pressure increased in 3 cases,and reduced to normal after given a kind of IOP-lowering drug.No other adverse reactions in the eyes and the whole body were observed.Conclusion Dexamethasone intravitreal implant can effectively improve macular edema after vitrectomy with silicone oil tamponade and improve vision in the short term.

关 键 词：植入剂 玻璃体内 糖皮质激素 地塞米松 水肿 黄斑 硅油填充眼 效果 治疗 

分 类 号：R779.6[医药卫生—眼科]