术中前房注射曲安奈德在糖尿病性白内障中的应用

Application of triamcinolone acetonide injected into anterior chamber during the operation on diabetic cataract

目的探讨术中前房注射曲安奈德在糖尿病性白内障中的应用。方法选取2012年1月~2018年2月眼科住院治疗的糖尿病性白内障患者72例(72眼),知情同意后采用抛硬币法分成曲安奈德组(n=36)和对照组(n=36)。两组均在在表面麻醉下行超声乳化白内障联合人工晶状体植入术,曲安奈德组术中侧切口注入1mg曲安奈德和复方平衡盐溶液以维持前房。对照组按常规方法注入复方平衡盐溶液以形成维持前房。观察并比较两组术后角膜水肿、瞳孔粘连、前房纤维蛋白渗出及后囊浑浊的发生率。结果曲安奈德组术后角膜水肿发生率低于对照组(χ2=4.50,P<0.05)。两组术后瞳孔粘连发生率相接近(χ2=0.26,P>0.05)。曲安奈德组术后前房轻、中、重度渗出总发生率低于对照组(χ2=6.77,P<0.01)。曲安奈德组术后后囊浑浊的发生率低于对照组(χ2=4.13,P<0.05)。结论术中前房注射曲安奈德在糖尿病性白内障中的应用效果较确切,能显著减轻术后角膜水肿和前房纤维蛋白渗出,降低后囊浑浊的发生率。

Objective To discuss the application of triamcinolone acetonide injected into anterior chamber during the operation on diabetic cataract. Methods 72 cases of patients(72 eyes) with diabetic cataract, who were given the medical treatment in Department of Ophtalmology from January 2012 to February 2018, were selected, and divided into triamcinolone acetonide group(n=36) and control group(n=36) by tossing the coin after the informed consent. The patients in two groups were given phacoemulsificationcataract extraction?combined with?intraocular lens implantation under topical anesthesia, while the patients in triamcinolone acetonide group were given 1mg triamcinolone acetonide and compound equilibrium salt solution, which were injected into lateral incision, to maintain anterior chamber. The occurrence rates of corneal edema, caligo pupillae, fibrous exudation of the anterior chamber and again capsulorhexis of patients in two groups were observed and compared after the operation. Results The occurrence rate of corneal edema after the operation of patients in triamcinolone acetonide group was lower than that in control group(χ2=4.50, P<0.05). The occurrence rates of caligo?pupillae in both groups were approximate(χ2=0.26,P>0.05). The total occurrence rates of light, mediate and severe exudation of anterior chamber of patients in triamcinolone acetonide group after the operation were much lower than those in control group(χ2=6.77, P<0.01). The occurrence rate of again capsulorhexis of patients in triamcinolone acetonide group after the operation was much lower than that in control group(χ2=4.13, P<0.05). Conclusion The application of triamcinolone acetonide injected into anterior chamber has reliable curative effect on diabetic cataract during the operation, which can obviously reduce the corneal edema and fibrous exudation of the anterior chamber, as well as the occurrence rate of again capsulorhexis.