伴有葡萄膜炎的白内障术后药物治疗的效果

Efficacy of postoperative medication in the treatment of cataract with uveitis

目的评价应用双氯芬酸钠联合曲安奈德对伴有葡萄膜炎的白内障术后的效果。方法对2016年1月至2018年6月北京潞河医院接诊的85例伴有葡萄膜炎的白内障进行回顾性研究。患者通过随机数表法分为观察组45例和对照组40例,两组均择期行晶状体超声乳化人工晶状体植入术。对照组术后接受曲安奈德结膜下注射及使用妥布霉素地塞米松滴眼液治疗;观察组在对照组用药基础上,增加双氯芬酸钠滴眼液治疗。两组均连续用药1个月,进行比较。结果治疗后1个月,观察组房水sCD44、TGF-β2、MCP-1均较对照组低,差异有统计学意义(P<0.05);治疗前后两组之间眼压差异无统计学意义(P>0.05);观察组最佳矫正视力、前房反应0级发生率、角膜水肿、黄斑水肿及畏光症状总发生率均好于对照组,差异均有统计学意义(P<0.05)。两组用药期间不良反应发生率差异无统计学意义(P>0.05)。结论应用双氯芬酸钠联合曲安奈德对伴葡萄膜炎白内障的术后效果显著,有利于降低术后房水sCD44、TGF-β2、MCP-1的表达,缓解前房反应,减少并发症。

Objective To evaluate the efficacy of postoperative application of diclofenac sodium combined with triamcinolone acetonide in the treatment of cataract with uveitis. Methods The data of 85 patients of cataract with uveitis from Jan. 2016 to Jun. 2018 in Luhe Hospital were studied retrospectively.According to the random number table, all patients were divided into the observation group and the control group.The two groups were performed phacoemulsification and intraocular lens implantation.The control group, 40 cases, received injection of triamcinolone subconjunctival postoperatively, and treated with Tobramycin and Dexamethasone ophthalmic suspension eye drops after injection.The observation group, 45 cases, received diclofenac sodium eye drops on the basis of eyes drops of the control group.The course of medication was 1 month. The changes after treatment were compared between the two groups. Results The aqueous humor sCD44, TGF-β2 and MCP-1 in the observation group at 1 month after treatment were significantly better than those in the control group (P<0.05). There was no significant difference in intraocular pressure between the two groups after treatment (P>0.05). In the observation group, the visual acuity, the incidence of grade 0 anterior chamber reaction, the total incidence of corneal edema, macular edema and photophobia were significantly better than those in the control group (P<0.05). The difference in the incidence of adverse reactions was not significant between the two groups during medication (P>0.05). Conclusion Application of Diclofenac sodium combined with triamcinolone acetonide is effective for cataract with uveitis, can reduce the aqueous humor sCD44, TGF-β2 and MCP-1 levels, alleviate anterior chamber reaction, and reduce the complications.