曲伏前列腺素预防DR玻璃体切除术后24h高眼压的临床意义

Prevention effect of travoprost on high intraocular pressure within 24 hours after diabetic retinopathy vitrectomy

目的: 探索术前应用0.04g/L曲伏前列腺素滴眼液对预防糖尿病视网膜病变(diabetic retinopathy,DR)行玻璃体切除术后24h高眼压的临床意义。方法: 选择行玻璃体切除联合硅油、C3F8气体或平衡液(BSS)填充术治疗的102例102眼DR患者,分为A、B两组,其中B组术前60min用0.04g/L曲伏前列腺素滴眼液1滴点术眼,观察两组患者手术前24h与手术后24h最佳矫正视力、眼底情况,同时以Goldmann眼压仪测量眼压并分析。结果: 两组术眼术后24h平均眼压均高于对侧眼(t=2.17,2.09;均P<0.05),也均高于自身术前24h平均眼压(t=2.41,2.28;均P<0.05)。术后24h,A组高眼压(以平均眼压≥25mmHg为高眼压标准)及BCVA较术前下降发生率大于B组(χ2=4.86,3.99;均P<0.05)。A组患者术后24h最佳矫正视力低于B组,但差异均无统计学意义(t=1.43,P>0.05)。结论: 术前应用0.04g/L曲伏前列腺素滴眼液可以减少DR玻璃体切除术后24h高眼压发生,改善高眼压对视网膜及视盘血供的影响,对预防DR玻璃体切除术后高眼压所致视功能损害有意义。

·AIM： To observe the clinical significance of travoprost for prevention of high intraocular pressure （lOP） within 24 hours after diabetic retinopathy （DR） vitrectomy.·METHODS： A total of 102 patients （102 eyes） with DR who underwent vitrectomy and related literatures were analyzed and compared. All patients were randomly assigned to group A （ vitrectomy combined with intravitreal silicone oil, C3 F8 or balanced salt solution tamponade group, 51 patients 51 eyes） or group B （surgical therapy is the same as the group A, while instilling one drop of 0.04g/L travoprost eyedrops in the inferior cul-de-sac about 60 minutes before the surgery, 51 patients 51 eyes）. The changes of lOP, best-corrected visual acuity （BCVA） and ophthalmoscope observations within 24 hours respectively before and after the surgery were counted and analyzed.·RESULTS： The mean lOP of each group within 24 hours after the surgery was higher than the contralateral eyes （t=2.17 and 2.09, P〈0.05） and the mean lOP within 24 hours before the surgery （t= 2.41 and 2.28, P〈0.05）. The incidence of high IOP （the high lOP was defined as mean IOP≥25mmHg） and decreased BCVA in group Atranscended group B （X2 = 4. 86 and 3. 99, P〈0. 05）. Meanwhile, the mean BCVA of group A within 24 hours after the surgery was slightly worse than that of group B （t=1.43, P〉0.05）.· CONCLUSION： The preliminary result in our scrutiny showed that the preoperative treatment of 0. 04g/L travoprost eyedrops was well tolerated with the significant reduction in the incidence of high lOP and decrease in BCVA within 24 hours after DR vitrectomy. It has clinical sfgnificance about the prevention of visual impairment owing to high lOP within 24 hours after DR vitrectomy.