Miyake K, Masuda K, Shirato S, Oshika T, Eguchi K, Hoshi H, Majima Y, Kimura W, Hayashi F
Miyake Eye Hospital, Nagoya, Japan.
Jpn J Ophthalmol. 2000 Jan-Feb;44(1):58-67. doi: 10.1016/s0021-5155(99)00176-8.
To compare a nonsteroidal topical solution (0.1% diclofenac) to a steroidal topical solution (0.1% fluorometholone) in preventing cystoid macular edema (CME) and disruption of the blood-aqueous barrier.
A multicentered, prospective clinical trial was performed on eyes undergoing phacoemulsification followed by implantation of a foldable acrylic intraocular lens by the envelope technique. The presence and degree of cystoid macula edema (CME) was determined by fluorescein angiography. A breakdown of the blood-aqueous barrier was determined by laser flare-cell photometry.
Five weeks after surgery, CME was present in 3 of 53 eyes (5.7%) receiving diclofenac and in 29 of 53 eyes (54.7%) receiving fluorometholone. This difference was statistically significant (P < .001). The amount of flare in the anterior chamber at 3 days, 1, 2, 5, and 8 weeks after surgery was also significantly lower (P < .01-P < .001) in the diclofenac group. The degree of flare at 3 days, 1, 2, 5, and 8 weeks after surgery was significantly higher in eyes with CME (P < .001).
These findings suggest that diclofenac effectively prevents CME following cataract surgery and that CME is closely related to the breakdown of the blood-aqueous barrier.
比较一种非甾体类局部用药溶液（0.1%双氯芬酸）与一种甾体类局部用药溶液（0.1%氟米龙）在预防黄斑囊样水肿（CME）和血-房水屏障破坏方面的效果。
对采用信封式技术行白内障超声乳化吸除术并植入可折叠丙烯酸人工晶状体的患者进行多中心前瞻性临床试验。通过荧光素血管造影确定黄斑囊样水肿（CME）的存在及程度。通过激光散射细胞光度测定法确定血-房水屏障的破坏情况。
术后5周，接受双氯芬酸治疗的53只眼中有3只（5.7%）出现CME，接受氟米龙治疗的53只眼中有29只（54.7%）出现CME。这种差异具有统计学意义（P <.001）。双氯芬酸组术后3天、1周、2周、5周和8周前房内的闪光量也显著更低（P <.01 - P <.001）。出现CME的眼在术后3天、1周、2周、5周和8周的闪光程度显著更高（P <.001）。
这些发现表明双氯芬酸能有效预防白内障术后的CME，且CME与血-房水屏障的破坏密切相关。
