前房注射不同剂量曲安奈德预防白内障术后炎症反应的临床分析

Clinical analysis of anterior chamber injection of different doses of triamcinolone acetonide for postcataract inflammation

目的探讨老年性白内障术中前房注射不同剂量曲安奈德对预防术后炎症反应的效果。方法选取220例老年性白内障患者,随机分为三组,对照组术后滴加妥布霉素地塞米松滴眼液,TA1和TA2组术后分别在前房注射0.5mg、1.0mg TA,并滴加妥布霉素滴眼液。观察三组术后12h、1d、3d、5d的视力及眼压,前房细胞数和房水闪辉。结果术毕滴加糖皮质激素滴眼液与注射不同剂量的曲安奈德,在控制炎症反应程度上差别不大。术后三组前房细胞数相比,无统计学差异(P>0.05),术后三组房水闪辉情况相比,无统计学差异(P>0.05);三组患者术后12h眼压较高,随着时间推进,眼压趋于恢复正常,组间比较无明显差异(P>0.05);术后1d、3d、5d时TA1和TA2组视力矫正情况好于对照组(P<0.05)。结论对于老年性白内障患者,前房注射0.5mg和1mg TA均能较为有效降低前房炎症反应,促进视力恢复,可以不用糖皮质激素滴眼液,从而减少糖皮质激素滴眼液不良反应发生几率。

Objective To explore the effects of different doses of triamcinolone acetonide(TA)in senile postcataract by anterior chamber injection to prevent inflammation.Methods A total of220senile cataract patients were randomly divided into3groups:control group,TA1group and TA2group.Control group was given tobramycin and dexamethasone ophthalmic suspension to prevent postcataract inflammation,while TA1and TA2groups respectively received anterior chamber injection of0.5mg,and1mg TA besides the eye drop.The vision,intraocular pressure,cell count in the anterior chamber and tyndall of the3groups were observed before surgery and12h,1d,3d,and5d after surgery.Results After surgery,there was no significant difference among the3groups in the prevention of inflammation,cell count,and aqueous flare(P>0.05).The intraocular pressure of all groups was the highest12h after surgery,which gradually returned normal,and no significant difference was observed among the three groups(P>0.05).The patients'vision correction was better in the TA1and TA2groups than in the control group(P<0.05).Conclusion For senile cataract patients,anterior chamber injection of0.5mg and1mg TA can reduce inflammation in the anterior chamber,and promote recovery of vision,thus reducing the use of eye drops with glucocorticoid and avoiding side effects.