白内障术中应用非甾体类抗炎药抑制后发性白内障的临床研究

The effect of nonsteroidal anti-inflammatory agents on prevention of posterior capsular opacity in cataract surgery

目的:观察白内障超声乳化术中应用非甾体类抗炎药双氯芬酸钠水分离联合转核技术对晶状体后囊膜混浊的抑制作用。方法:将179例(200眼)老年性白内障患者随机分为4组分别行超声乳化白内障摘除术。A组使用平衡盐液进行水分离,B组使用利多卡因水分离,C组使用双氯芬酸钠水分离,D组使用双氯芬酸钠水分离并联合转核。观察患者术后视力、角膜内皮细胞密度、晶状体后囊膜混浊(posterior capsular opacity,PCO)分级情况。结果:各组术后各时期最佳矫正视力和角膜内皮细胞密度差异无统计学意义(P>0.05)。各组PCO分级差异有统计学意义(P<0.001),C组和D组PCO分级低于A、B对照组,且D组PCO分级低于C组。结论:双氯芬酸钠水分离联合核旋转能有效降低后发性白内障发生率,且眼内使用较为安全。

Objective：To investigate the safety and effectiveness of hydrodissection with diclofenac sodium and nuclear rotation on the prevention of posterior capsular opacity.Methods：179 patients（200 eyes）with age-related cataract were divided into four groups randomly and underwent phacoemulsification with IOL implantation.Hydrodissection was done with balanced salt solution,lidocaine,diclofenac sodium,diclofenac sodium and nuclear rotation in group A,B,C,and D respectively.Visual acuity,corneal endothelial cell density and grade of posterior capsular opacity（PCO） were measured.Results：There were no significant differences between four groups in the best corrected visual acuity and corneal endothelial cell density（P0.05）.The PCO score of group C and D were lower than group A and B,and the PCO score of group D was lower than group C.Conclusion：Hydrodissection with diclofenac sodium and nuclear rotation is effective in preventing posterior capsular opacity and can be safely used in ophthalmic surgical practice.