1g/L溴芬酸鈉水合物滴眼液對白內障術后黃斑水腫的預防

劉盛春,王利群

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·臨床研究·

1g/L溴芬酸鈉水合物滴眼液對白內障術后黃斑水腫的預防

劉盛春1,王利群2

?METHODS:In this prospective, randomized, controlled clinical trial, the cases with age related cataract after phacoemulsification combined with intraocular lens implantation were randomly divided into two groups, each group of 118 eyes. The cases in experimental group received the treatment of 1g/L bromfenac sodium hydrate ophthalmic solution for 2d preoperatively and 4wk postoperatively, combined with tobramycin dexamethasone eye drops for 2wk postoperatively. The cases in control group received the treatment of tobramycin dexamethasone eye drops for 2wk postoperatively. Central subfield mean thickness(CSMT) was measured within 2d before surgery as well as on 1d, 1, 4, 12wk after surgery and the incidence of macular edema was calculated after surgery.

?RESULTS:There was no significant difference in CSMT between two groups before surgery and on 1d, 1, 12wk after surgery (P>0.05). CSMT was significantly lower in experimental group (251.57±6.814μm) than in control group (262.41±7.295μm) on 4wk after surgery (P<0.05). The incidence of macular edema in experimental group on 1d, 1, 4, 12wk after surgery were 0, 0, 0.9% and 0.9%, respectively, while in control group were 0, 0.9%, 8.5% and 1.7%, respectively. There was significant difference in the incidence of macular edema between two groups only on 4wk after surgery(P<0.05).

?CONCLUSION:The thickening of central subfield can be effectively prevented and the incidence of macular edema can be reduced with 1g/L bromfenac sodium hydrate ophthalmic solution performed before and after phacoemulsification.

目的:探討1g/L溴芬酸鈉水合物滴眼液對白內障超聲乳化術后黃斑水腫的預防作用。

方法:采用前瞻性臨床隨機對照試驗。將行白內障超聲乳化吸除聯合人工晶狀體植入術的年齡相關性白內障患者隨機分為兩組，每組118眼。試驗組：術前2d和術后4wk應用1g/L溴芬酸鈉水合物滴眼液，聯合術后2wk應用妥布霉素地塞米松滴眼液；對照組：術后2wk應用妥布霉素地塞米松滴眼液。分別在術前2d內，術后1d、1、4、12wk測定黃斑中心亞區域平均厚度(CSMT)，并計算術后黃斑水腫發生率。

結果:術前、術后1d,1、12wk試驗組與對照組CSMT比較，差異均無統計學意義(P>0.05)；術后4wk試驗組CSMT為251.57±6.814μm，低于對照組的262.41±7.295μm，差異有統計學意義(P<0.05)；術后1d,1、4、12wk試驗組黃斑水腫發生率分別為0、0、0.9%、0.9%，對照組分別為0、0.9%、8.5%、1.7%，兩組黃斑水腫發生率比較，僅術后4wk差異有統計學意義(P<0.05)。

結論:白內障超聲乳化術前和術后應用1g/L溴芬酸鈉水合物滴眼液，能有效預防術后黃斑中心亞區域增厚，減少黃斑水腫發生率。

溴芬酸鈉；白內障超聲乳化術；黃斑水腫；黃斑厚度；光學相干斷層掃描

引用：劉盛春,王利群.1g/L溴芬酸鈉水合物滴眼液對白內障術后黃斑水腫的預防.國際眼科雜志2016;16(12):2250-2253

0引言

黃斑水腫是白內障超聲乳化吸除術后常見并發癥，是影響視力恢復的主要原因之一，如何降低白內障術后黃斑水腫發生率是目前白內障研究的一個重點。手術后引起的一系列由前列腺素介導的炎性反應導致黃斑區視網膜毛細血管通透性增加，神經上皮層內細胞間隙液體積存，從而發生黃斑水腫，因此抗炎療法成為黃斑水腫的常用治療手段。溴芬……