地塞米松玻璃体内植入剂治疗白内障术后人工晶状体眼黄斑囊样水肿的短期疗效观察

Short-term outcomes of dexamethasone intravitreal implant in the treatment of pseudophakic cystoid macular edema after cataract surgery

目的观察地塞米松玻璃体内植入剂(Ozurdex)治疗白内障术后人工晶状体眼黄斑囊样水肿(PCME)的疗效及安全性。方法回顾性分析14例(16眼)PCME患者的临床资料。所有患眼均接受玻璃体内注射地塞米松玻璃体内植入剂0.7 mg的治疗,治疗后随访6个月,随访期间若发现PCME复发,则再次注射地塞米松玻璃体内植入剂。比较治疗前与治疗后1个月、3个月、6个月患眼最佳矫正视力(BCVA)、眼压及黄斑中心凹视网膜厚度(CMT)等的变化。结果治疗前及治疗后1个月、3个月、6个月患眼的BCVA(logMAR)分别为0.61±0.17、0.15±0.10、0.14±0.10、0.12±0.10,CMT分别为(540.38±76.10)μm、(229.13±13.27)μm、(227.13±13.32)μm、(225.56±14.88)μm,与治疗前相比,治疗后1个月、3个月及6个月患眼的BCVA均显著改善,CMT均显著降低(均为P<0.001)。治疗前及治疗后1个月、3个月、6个月患眼眼压相比,差异无统计学意义(F=0.751,P=0.087)。随访6个月期间,仅1眼行两次地塞米松玻璃体内植入剂注射治疗;2眼出现眼压轻度升高,给予局部降眼压治疗后恢复正常。所有患者随访期间均未出现与药物、眼部治疗相关的并发症。结论地塞米松玻璃体内植入剂治疗PCME短期疗效显著。

Objective To evaluate the efficacy and safety of dexamethasone intravitreal implant(Ozurdex)in the treatment of pseudophakic cystoid macular edema(PCME)after cataract surgery.Methods The clinical data of 14 patients(16 eyes)with PCME were retrospectively analyzed.All eyes were intravitreally injected with 0.7 mg of dexamethasone intravitreal implant.During the follow-up 6 months,in case of the recurrence of PCME,dexamethasone intravitreal implant was injected again.The best corrected visual acuity(BCVA),intraocular pressure(IOP),and central macular thickness(CMT)were recorded and compared preoperatively,1 month,3 months,and 6 months postoperatively.Results The BCVA(logMAR)before treatment,at 1,3 and 6 months after treatment was 0.61±0.17,0.15±0.10,0.14±0.10,and 0.12±0.10,respectively,and the CMT was(540.38±76.10)μm,(229.13±13.27)μm,(227.13±13.32)μm,and(225.56±14.88)μm,respectively.Compared with the preoperative conditions,the BCVA of all eyes significantly improved and CMT significantly reduced at 1 month,3 months,and 6 months after treatment(all P<0.001),while the IOP showed no statistical difference(F=0.751,P=0.087).During the 6-month follow-up,only one eye underwent intravitreal injection of dexamethasone twice.IOP increased slightly in two eyes and then returned to normal after IOP-lowering treatment.All patients had no complications related to drug and eye treatment during follow-up.Conclusion Dexamethasone intravitreal implant has a significant effect in the treatment of PCME in a short time.