抗青光眼药物对粘弹剂辅助白内障超声乳化手术后眼压的作用

Effect of antiglaucoma agents on postoperative intraocular pressure after phacoemulsification with viscoelastics

目的:探讨抗青光眼药物在防治粘弹剂辅助白内障超声乳化手术后早期眼压升高中的作用。方法:150例150眼白内障患者行玻璃酸钠辅助超声乳化术,术程顺利无并发症。按术后抗青光眼药物将患者随机分为5组:10g/L派立明组,2g/L阿法根组,口服醋氮酰胺250mg组,5g/L噻马心安组及未用药组(空白对照组)。术前、术后6,12,24h及1wk测量眼压。结果:术前各组间眼压均值无明显差别。术后6,12h及24h用药组眼压较对照组低(P<0.01),术后6h各组眼压均升高,以对照组显著。各组术后12h眼压达峰值。此时眼压>21mmHg所占比例,抗青光眼药物组各组间比较无差异,对照组明显高于其它组。术后24h用药组眼压均降低,对照组仍保持高值。术后1wk,各组间无明显差异。结论:抗青光眼药物对玻璃酸钠辅助超声乳化手术后引起的眼压增高均有降低作用。

AIM：To investigate the effectiveness of antiglaucoma agents in preventing intraocular pressure （IOP） elevation during the early period after phacoemulsification with the help of viscoelastics. METHODS： One hundred and fifty patients （150 eyes） with uncomplicated cataract were scheduled for phacoemulsification using sodium hyaluronate as adjunct. Patients were randomly assigned to five groups： postoperative application of topical Azopt 10g/L, Alphagan 2g/L, oral acetazolamide 250mg, timolol 5g/L, and no ocular hypotensive agent （control group）. The IOP was measured preoperatively as well as 6 hours, 12 hours, 24 hours, and 1 week after surgery. RESULTS： The mean preoperative IOP values were not significantly different between groups. At 6, 12 and 24 hours postoperatively, the mean IOP was significantly lower in all groups receiving an ocular hypotensive agent than that in the control group （P〈0. 01 ）. At 6 hours after surgery, the mean IOP significantly increased in all groups but was not as prominent as the control group. At 12 hours after surgery the mean IOP was at the peak in all groups. The percentage of eyes with IOP higher than 21mmHg at 12 hours after phacoemulsification were not significantly different between antiglaucoma agent groups, but IOP is obviously higher in the control group. At 24 hours after surgery, the mean IOP decreased significantly in all ocular hypotensive agent groups, but remained significantly high in the control group. One week after surgery, there were no significant differences between groups. CONCLUSION： All of the hypotensive agents have similar effects in reducing IOP increase after phacoe- mulsification performed with sodium hyaluronate as adjunct.