非甾体类药物预防飞秒激光辅助白内障术中瞳孔缩小的观察与分析

发布时间：2018-01-15 02:23

本文关键词：非甾体类药物预防飞秒激光辅助白内障术中瞳孔缩小的观察与分析　出处：《眼科新进展》2016年05期 　论文类型：期刊论文

【摘要】：目的探讨飞秒激光术后眼内前列腺素E2(prostaglandin E2)浓度的变化与瞳孔缩小的关系,同时比较术前应用两种非甾体类药物(nonsteroidal drugs,NSAIDs)预防飞秒激光辅助白内障术中瞳孔缩小的效果。方法前瞻性队列研究。研究对象为2014年6月至2015年3月于天津医科大学眼科医院白内障科行白内障手术的老年性白内障患者120例(120眼),根据手术方式及用药分为4组,其中拟行传统超声乳化手术30例(30眼)为A组;拟行飞秒激光辅助白内障手术90例(90眼)随机分为3组,其中空白对照组为B组,术前应用1 g·L~(-1)普拉洛芬滴眼液为C组,术前应用1 g·L~(-1)双氯芬酸钠滴眼液为D组。收集包括患者年龄、性别、晶状体核分级、术前充分散瞳后以及完成飞秒激光或手工透明角膜切口后瞳孔直径等临床资料,测量所有样本中PGE2浓度。结果 A、B、C、D四组中PGE2浓度分别为(48.25±10.52)pg·m L~(-1)、(124.14±8.97)pg·m L~(-1)、(18.28±3.49)pg·m L~(-1)、(19.05±3.13)pg·m L~(-1);B组与A、C、D组差异均有统计学意义(均为P0.000 1),C组与D组差异无统计学意义(P0.05)。A、B、C、D四组术中瞳孔缩小的发生率分别为6.67%(2/30)、20.00%(6/30)、3.33%(1/30)、3.33%(1/30);B组与A、C、D组差异均有统计学意义(均为P0.05),C组与D组差异无统计学意义(χ2=0.001,P0.05)。瞳孔缩小与年龄、性别及晶状体核分级均无相关性(均为P0.05)。发生瞳孔缩小者与未发生瞳孔缩小者PGE2浓度分别为(130.74±8.76)pg·m L~(-1)、(120.86±7.27)pg·m L~(-1),差异有统计学意义(P0.05),瞳孔缩小程度与PGE2浓度无相关性(P0.05)。结论飞秒激光术后瞳孔缩小可能与房水中PGE2浓度升高有关,术前局部应用NSAIDs能降低眼内PGE2浓度,减少飞秒激光术后瞳孔缩小的发生。
[Abstract]:Objective to investigate the relationship between intraocular prostaglandin E2 (prostaglandin E2) concentration and pupil dilatation after femtosecond laser surgery. At the same time, two kinds of nonsteroidal drugs were compared before operation. NSAIDS). Effect of preventing pupil dilation in femtosecond laser assisted cataract surgery. Methods prospective cohort study was conducted from June 2014 to March 2015 in the Department of Cataract, Department of Ophthalmology, Tianjin Medical University. 120 cases of senile cataract undergoing surgery (. 120 eyes. The patients were divided into 4 groups according to the method of operation and medication. 30 eyes of 30 patients who were scheduled to undergo traditional phacoemulsification were divided into two groups: group A (n = 30); 90 cases (90 eyes) of femtosecond laser assisted cataract surgery were randomly divided into 3 groups: group B (blank control group) and group C (1 g 路L ~ (-1)) Praproprofen eye drops before operation. Group D was treated with 1 g 路L ~ (-1) diclofenac sodium eye drops before operation. The collection included age, sex and nuclear grade of lens. Clinical data such as pupil diameter after full mydriasis before operation and after femtosecond laser or manual transparent corneal incision were used to measure the concentration of PGE2 in all samples. The concentrations of PGE2 in group D were 48.25 卤10.52 PG 路mL ~ (-1) and 124.14 卤8.97 PG 路mL ~ (-1), respectively. 18.28 卤3.49 PG 路mL ~ (-1) ~ (-1) ~ 19.05 卤3.13 ~ (?) PG 路m ~ (-1) ~ (-1); There was no significant difference between group B and group D (P 0.000 1) and group D (P 0. 05. 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, P < 0. 05, respectively). The incidence of pupil dilatation in group D was 6.67 / 30 and 20.00, respectively. There was no significant difference between group B and group A (P 0.05) and group D (蠂 2 0.001). There was no correlation between sex and nuclear grade of lens (P 0.05). The PGE2 concentration in patients with or without pupil dilatation was 130.74 卤8.76 PG 路mL ~ (-1), respectively (P < 0.05). -1). The difference was statistically significant (P 0.05). There was no correlation between pupil dilatation and PGE2 concentration. Conclusion pupil dilation after femtosecond laser surgery may be related to the increase of PGE2 concentration in aqueous humor. Preoperative local application of NSAIDs can reduce intraocular PGE2 concentration and reduce pupil dilation after femtosecond laser.
【作者单位】：天津医科大学眼科医院;
【分类号】：R779.6
【正文快照】： 2009 年NAGY等[1-2]先报道运用Len Sx完成飞秒激光辅助白内障超声乳化手术,包括晶状体前囊膜切开、预劈核、角膜切口及角膜弧形切口,标志着该项技术成功地进入临床。然而,部分患者在飞秒激光完成后出现瞳孔缩小,发生率为9. 5% ~25. 0%[3-5]。在SCHULTZ等[6]的研究中发现,飞秒

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