本文關(guān)鍵詞：非甾體類藥物預(yù)防飛秒激光輔助白內(nèi)障術(shù)中瞳孔縮小的觀察與分析　出處：《眼科新進(jìn)展》2016年05期 　論文類型：期刊論文

  更多相關(guān)文章： 非甾體類藥物 白內(nèi)障 飛秒激光 超聲乳化 瞳孔縮小

【摘要】：目的探討飛秒激光術(shù)后眼內(nèi)前列腺素E2(prostaglandin E2)濃度的變化與瞳孔縮小的關(guān)系,同時比較術(shù)前應(yīng)用兩種非甾體類藥物(nonsteroidal drugs,NSAIDs)預(yù)防飛秒激光輔助白內(nèi)障術(shù)中瞳孔縮小的效果。方法前瞻性隊列研究。研究對象為2014年6月至2015年3月于天津醫(yī)科大學(xué)眼科醫(yī)院白內(nèi)障科行白內(nèi)障手術(shù)的老年性白內(nèi)障患者120例(120眼),根據(jù)手術(shù)方式及用藥分為4組,其中擬行傳統(tǒng)超聲乳化手術(shù)30例(30眼)為A組;擬行飛秒激光輔助白內(nèi)障手術(shù)90例(90眼)隨機分為3組,其中空白對照組為B組,術(shù)前應(yīng)用1 g·L~(-1)普拉洛芬滴眼液為C組,術(shù)前應(yīng)用1 g·L~(-1)雙氯芬酸鈉滴眼液為D組。收集包括患者年齡、性別、晶狀體核分級、術(shù)前充分散瞳后以及完成飛秒激光或手工透明角膜切口后瞳孔直徑等臨床資料,測量所有樣本中PGE2濃度。結(jié)果 A、B、C、D四組中PGE2濃度分別為(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組與A、C、D組差異均有統(tǒng)計學(xué)意義(均為P0.000 1),C組與D組差異無統(tǒng)計學(xué)意義(P0.05)。A、B、C、D四組術(shù)中瞳孔縮小的發(fā)生率分別為6.67%(2/30)、20.00%(6/30)、3.33%(1/30)、3.33%(1/30);B組與A、C、D組差異均有統(tǒng)計學(xué)意義(均為P0.05),C組與D組差異無統(tǒng)計學(xué)意義(χ2=0.001,P0.05)。瞳孔縮小與年齡、性別及晶狀體核分級均無相關(guān)性(均為P0.05)。發(fā)生瞳孔縮小者與未發(fā)生瞳孔縮小者PGE2濃度分別為(130.74±8.76)pg·m L~(-1)、(120.86±7.27)pg·m L~(-1),差異有統(tǒng)計學(xué)意義(P0.05),瞳孔縮小程度與PGE2濃度無相關(guān)性(P0.05)。結(jié)論飛秒激光術(shù)后瞳孔縮小可能與房水中PGE2濃度升高有關(guān),術(shù)前局部應(yīng)用NSAIDs能降低眼內(nèi)PGE2濃度,減少飛秒激光術(shù)后瞳孔縮小的發(fā)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 鹵10.52 PG 路mL ~ (-1) and 124.14 鹵8.97 PG 路mL ~ (-1), respectively. 18.28 鹵3.49 PG 路mL ~ (-1) ~ (-1) ~ 19.05 鹵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 鹵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.
【作者單位】： 天津醫(yī)科大學(xué)眼科醫(yī)院;
【分類號】：R779.6
【正文快照】： 2009 年NAGY等[1-2]先報道運用Len Sx完成飛秒激光輔助白內(nèi)障超聲乳化手術(shù),包括晶狀體前囊膜切開、預(yù)劈核、角膜切口及角膜弧形切口,標(biāo)志著該項技術(shù)成功地進(jìn)入臨床。然而,部分患者在飛秒激光完成后出現(xiàn)瞳孔縮小,發(fā)生率為9. 5% ~25. 0%[3-5]。在SCHULTZ等[6]的研究中發(fā)現(xiàn),飛秒

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