白内障术后药源性角膜损伤的相关因素分析

Analysis of factors related to drug-induced corneal lesions after cataract surgery

目的 分析白内障术后妥布霉素地塞米松滴眼液滴眼引起药源性角膜损伤发生的相关因素.方法 对白内障术后滴用妥布霉素地塞米松滴眼液者193例（197眼）进行临床回顾,其中24例（25眼）发生药源性角膜损伤,对引起药源性角膜损伤的相关因素进行分析.结果 药源性角膜损伤以术后2～3周发生的最多;以浅层点状角膜上皮浑浊所占比例最高.按高血压、高血糖、高龄等相关因素分析,损伤组相关性明显高于无损伤组,差异有统计学意义（χ2=7.90,P=0.01;χ2=10.41,P=0.00χ2=8.95,P=0.00）;无损伤组术后视力及视力恢复时间明显好于药源性损伤组（χ2=5.63,P=0.02;t=12.20,P=0.01）.结论 白内障术后应用妥布霉素地塞米松引起的药源性角膜损伤明显影响术后的视力恢复;高血压、糖尿病以及高龄因素与药源性角膜损伤有关,白内障术后需要重视药源性角膜损伤的发生,对于合并高血压、糖尿病以及老年患者需要加强观察,注意合理用药.

Objective To analyze the related factors of drug-induced corneal lesions after cataract surgery.Methods 197 eyes of 193 cases who used tobramycin dexamethasone eye drops after cataract surgery were enrolled in this retrospective study.Totally 25 eyes of 24 cases were diagnosed as drug-induced corneal lesions.The factors related to drug-induced corneal lesions were analyzed.Results Most druginduced corneal lesions were taken placed at 2 to 3 weeks after surgery and the main corneal lesion was superficial punctate corneal opacity.Hypertension,diabetes and aging were the most common risk factors which related to drug-induced corneal lesions （P 〈 0.05）.The relevance in lesion group was higher than that in normal group and the difference was statistically significant （χ2 =7.90,P =0.01 ;χ2 =10.41,P =0.00 ; χ2 =8.95,P =0.00）.The vision acuity and visual recovery time of normal group were better than that of lesion group （χ2 =5.63,P =0.02; t =12.20,P =0.01）.Conclusion After cataract surgery,need to be taken seriously for drug-induced corneal lesions which can harm postoperative visual acuity,especially for elderly patients and patients with hypertension or diabetes.