先天性白内障术中玻璃体内注射曲安奈德抑制术后前房渗出的临床研究

A clinical study on the single intraoperative injection of triamcinolone acetonide to inhibit anterior chamber fibrin exudation after congenital cataract surgery

目的探讨玻璃体内注射曲安奈德(triamcinolone acetonide)混悬液对先天性白内障术后前房渗出的抑制作用及安全性。方法58例(72眼)先天性白内障患儿随机分为两组。试验组25例(31眼),施行小切口白内障囊外摘出人工晶状体植入及前段玻璃体切除术,术中向玻璃体内注射0.1mL(0.4mg)曲安奈德;对照组33例(41眼),施行同样手术,术中玻璃体内不注射曲安奈德。术后随访2个月,观察两组前房渗出情况,测量并比较手术前后眼压及角膜内皮细胞计数。结果术后,试验组轻度前房渗出3眼(9.68%),中度渗出1眼(3.22%),无重度渗出者,平均渗出发生时间为术后(28.25±5.56)d;对照组轻度渗出8眼(19.51%),中度渗出8眼(19.51%),重度渗出2眼(4.88%),平均渗出发生时间为术后(10.33±3.01)d。两组间比较差异有统计学意义(P<0.05)。两组眼压及角膜内皮细胞数差异无统计学意义。结论先天性白内障术中玻璃体内单次注入曲安奈德能有效地抑制并延缓前房渗出的发生。

Objective To investigate the efficiency and safety of anterior vitreons injection of Triameinolone Acetonide suspension （IVTA） for the inhibition of intraocular fibrin exudates after congenital cataract surgery. Methods 58 cases（ 72 eyes） of congenital cataract were divided into two groups at random：25 cases （31 eyes） in the study group were performed with small incision cataract extraction and 1OL implantation and anterior vitrectomy. 0.1 ml （4mg） TA was injected into vitreous cavity intraoperative; 33 cases （41 eyes） were performed the same operation but were not injected TA. We did a 2 month follow-up, observed the rate of anterior chamber fibrin exudates, measured and compared intraocular pressure （IOP） and cornea endothelium cells countsbetween two groups. Results In the study group, mild fibrin exudates was found in 3 eyes （9.68%） ,moderate fibrin exudates was found in 1 eyes （ 3.22% ） and no severe fibrin exudates was found after operation, and the mean time of exudation is 28.25±5.56 clays; In the control group, mild fibrin exudates was found in 8 eyes （19.51%） , moderate fibrin exudates was found in 8 eyes （ 19.51% ） and severe exudates was found in 2 eyes （4.88%） ,and the mean time of exudation is 10.33±3.01 days. The difference between two groups is statistically significant （P〈0.05）. There was no statistical difference in lOP and cornea endothelium cells counts. Conclusions Intravitreous injection of TA is an effective and safe way to inhibit fibrin exudation after congenital cataract surgery.