玻璃體內注射酮咯酸治療白內障術后慢性黃斑囊樣水腫

馬君擇

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·臨床報告·

玻璃體內注射酮咯酸治療白內障術后慢性黃斑囊樣水腫

馬君擇

?METHODS:A total of 38 patients with postoperative cystoid macular edema after cataract surgery coming to our hospital for treatment at 2014-2016 were collected. And the patients were treated with intravitreal ketorolac. After treatment, the patients were clinical examined with using optical coherence tomography (OCT) and fundus fluorescein angiography (FFA). And the clinical efficacy was observed. The corrected visual acuity, intraocular pressure and central retinal thickness of the cystoid macular area after cataract surgery were compared and analyzed before and after treatment in different periods (2 and 4wk, 3 and 6mo).

?RESULTS:Comparing with before treatment, the leakage was significantly reduced at the FFA after intravitreal ketorolac for the treatment of chronic cystoid macular edema. And the cystoid macular edema in patients regressed. At the same time, the corrected visual acuity was significantly increased (P<0.05), and the intraocular pressure was significantly improved (P<0.05), and the average macular thickness was significantly reduced (P<0.05). The difference was statistically significant.

?CONCLUSION:Intravitreal ketorolac for the treatment of chronic cystoid macular edema after cataract surgery has a good clinical efficacy. There is a important clinical significance.

目的：探討玻璃體內注射酮咯酸治療白內障術后慢性黃斑囊樣水腫的臨床療效。

方法：選取2014-03/2016-02我院收治的白內障手術后并發黃斑囊樣水腫患者38例，行玻璃體內注射酮咯酸治療。治療后，采用熒光素血管造影術(FFA)和光學相干斷層掃描(OCT)進行臨床檢查，觀察臨床療效，對比分析治療前及治療后2、4wk,3、6mo患者的矯正視力變化、眼壓、黃斑區中心視網膜厚度。

結果：與治療前相比，玻璃體內注射酮咯酸治療后FFA顯示患者滲漏顯著地減低，患者黃斑區水腫消退，同時，矯正視力顯著提高，差異有統計學意義(P<0.05)，眼壓顯著改善，差異有統計學意義(P<0.05)，黃斑區平均厚度顯著減少，差異有統計學意義(P<0.05)。

結論：玻璃體內注射酮咯酸治療白內障術后慢性黃斑囊樣水腫有良好的治療效果。

酮咯酸；白內障；術后慢性黃斑囊樣水腫；玻璃體內

引用：馬君擇.玻璃體內注射酮咯酸治療白內障術后慢性黃斑囊樣水腫.國際眼科雜志2016;16(12):2332-2334

0引言

黃斑囊樣水腫(cystoid macular edema，CME)是指一種黃斑區特征性的多囊樣水腫形態，它的產生是因為液體局限性積聚在視網膜的外叢狀層細胞外間隙，加之黃斑區Henle纖維呈放射狀排列。其發生的主要原因是在手術過程中相關的炎性介質被釋放，引起血-視網膜屏障破壞，導致黃斑區中心凹周圍的血管滲漏，從而使液體聚集于視網膜層間而引發水腫[1]。CME并不是獨立的眼部疾病，而往往是多種眼部疾病的并發癥。CME是白內障術后常見的并發癥之一，是引起白內障患者術后視功能障礙的主要原因之一[2-3]。……