围术期结膜下注射曲安奈德和地塞米松滴眼液预防白内障术后炎症和黄斑水肿的疗效及安全性比较  

Efficacy and safety of subconjunctival injection of triamcinolone acetonide and dexamethasone eye drops in preventing postoperative inflammation and macular edema in cataract surgery

作　　者：于卫星 Yu Weixing(Department of Cataract,Huairen Guangming Eye Hospital,Huairen,Shanxi 038300,China)

机构地区：[1]山西省怀仁市光明眼科医院白内障科,山西怀仁038300

出　　处：《中国药物与临床》2024年第21期1416-1419,共4页Chinese Remedies & Clinics

摘　　要：目的比较围术期单次球结膜下注射曲安奈德(TA)与地塞米松(DEX)滴眼液预防白内障术后眼部炎症和黄斑水肿的有效性、安全性和耐受性。方法回顾性分析2022年1月至2024年1月在山西省怀仁市光明眼科医院诊治的100例白内障手术患者,按治疗方法将患者分为TA组和DEX组,每组50例患者。TA组患者术后结膜下注射TA混悬液;DEX组患者接受常规局部DEX滴眼液治疗。术前及术后7、28和90 d进行相关检查。采用激光耀斑仪检测房水闪辉评估眼部炎症活动度;采用频域光学相干断层扫描评估中央视网膜厚度(CRT)。此外,同时检测2组患者眼压和矫正远视力。结果在术后90 d,DEX组房水闪辉增加,TA组恢复到正常水平,2组差异有统计学意义(P<0.05)。术后7 d、28 d和90 d,DEX组CRT增加,TA组没有增加,差异有统计学意义(所有P<0.05)。2组患者眼压和矫正远视力变化相似。眼耐受性良好,未观察到严重不良事件。结论围术期结膜下注射TA可有效预防白内障术后眼部炎症反应和黄斑水肿的发生。ObjectiveTo compare the efficacy,safety and tolerance of a single perioperative subconjunctival injection of triamcinolone acetonide(TA)and dexamethasone(DEX)in the prevention of ocular inflammation and macular edema after cataract surgery.MethodsA total of one hundred patients undergoing cataract surgery were included in the study.They admitted to Huairen Guangming Eye Hospital from January 2022 to January 2024 and were divided into TA group and DEX group according to different treatment methods,with 50 cases in each group.TA group received subconjunctival injection of triamcinolone acetonide suspension after operation.DEX group received conventional topical dexamethasone eye drops.The patients were followed up before operation and at 7,28 and 90 days after operation.The aqueous flare was detected by a laser flare instrument to evaluate ocular inflammatory activity;Central retinal thickness(CRT)was assessed by spectral-domain optical coherence tomogra-phy.In addition,the intraocular pressure and corrected distance visual acuity were measured in the two groups.ResultsAt 90 days after surgery,the aqueous flare still increased in the DEX group,while it returned to normal in the TA group.There was significant difference between the two groups(P<0.05).At 7 d,28 d and 90 d after surgery,the CRT increased in the DEX group,but not in the TA group(all P<0.05).The intraocular pressure and corrected distance visual acuity changes were similar between the two groups,with good ocular tolerance and no serious adverse events observed.ConclusionPerioperative subconjunctival TA can effectively prevent the occur-rence of ocular in flammation and macular oedema after cataract surgery.

关 键 词：白内障 曲安奈德 地塞米松 眼房水 视网膜 

分 类 号：R779.66[医药卫生—眼科]