玻璃体腔注射改良低剂量曲安奈德治疗白内障术后黄斑囊样水肿

Modified low-dose triamcinolone acetonide intravitreal injection for macular cystoid edema after cataract surgery

目的:探讨玻璃体腔注射改良低剂量曲安奈德(TA)治疗白内障术后黄斑囊样水肿(PCME)的疗效。方法:回顾性分析。选取2015-01/2018-12于我院就诊的典型PCME患者12例12眼行玻璃体腔注射改良低剂量TA。通过0.22μm的滤膜将TA混悬液置换成眼内灌注液,取置换后的TA溶液2mg/0.05mL注射。观察注药后2wk,1、3、6mo的最佳矫正视力、黄斑中央厚度、眼压、局部和全身并发症。结果:与注射前比较,所有患者注药后视力均显著提高;黄斑中央厚度显著减低(P<0.05),而眼压无明显升高(P>0.05),所有患者均未观察到眼部及全身并发症。结论:玻璃体腔注射改良低剂量TA治疗PCME安全、有效,克服了以往导致眼压升高的副作用,价格低廉,能够使患者受益。但尚需大宗病例的临床随机对照研究和长期疗效的随访观察。

AIM:To investigate the efficacy of intravitreal injection of modified low-dose of triamcinolone acetonide(TA)in the treatment of pseudophakic cystoid macular edema(PCME).METHODS:Retrospective study.Totally 12 eyes of 12 patients with PCME in our hospital were received intravitreal injection with modified low doses of TA from 2015-01 to 2018-12.The TA suspension was firstly resuspended by intraocular irrigating solution through 0.22um pore filter,then the new TA suspension(2mg/0.05mL)was injected intravitreally.The best-corrected visual acuity(BCVA),central macular thickness(CMT),intraocular pressure(IOP),and other side effects were recorded at 2wk,1mo,3mo and 6mo after injection,then compared the data with pre-injection(baseline)information.RESULTS:After intravitreal injection of modified low dose TA,all patients got improved BCVA and alleviated CMT,as compare to the baseline data,and the difference was statistically significant(P<0.05),but the difference of IOP was not significant(P>0.05).All patients had no recorded ocular or systemic complication.CONCLUSION:Intravitreal injection of modified low-dose TA is effective and safe for PCME,without significant increase in IOP.It s an affordable substitution to anti-vascular endothelial growth factor(anti-VEGF)agents.This still needs to be confirmed by the long-term follow-up study with large samples.