Barba K R, Samy A, Lai C, Perlman J I, Bouchard C S
Department of Ophthalmology, Loyola University Chicago, Maywood, Illinois 60153, USA.
J Cataract Refract Surg. 2000 Jun;26(6):893-7. doi: 10.1016/s0886-3350(00)00364-3.
To examine the effect of topical treatment with either steroidal or nonsteroidal anti-inflammatory drugs (NSAIDs) on the wound healing of corneal and limbal incisions using histologic criteria.
Loyola University Medical Center, Maywood, Illinois, USA.
Eighteen eyes of 9 cats were used for the study. All right eyes received a temporal limbal incision and the left eyes, a clear corneal incision. All eyes were treated with ofloxacin 0.3% postoperatively for 3 days. The animals were equally divided among 3 groups. Group 1 received topical steroid drops (prednisolone acetate 1%) for 7 days maximum; Group 2 received topical NSAID drops (ketorolac tromethamine 0.5%) for 7 days maximum; Group 3 received no additional treatment. One animal from each group was killed and the eye enucleated 3, 7, or 28 days postoperatively. The eyes were processed for staining with hematoxylin-eosin and smooth muscle actin, and corneal sections were evaluated in a blind fashion by an ophthalmic pathologist.
Three and 7 days after surgery (1) the limbal incision exhibited more prominent wound healing than the similarly treated clear corneal incision, and (2) the steroid-treated corneas had less wound healing than untreated or NSAID-treated corneas. At 28 days, the wounds in all eyes were almost completely healed.
Limbal incisions heal faster than clear corneal incisions. Steroids, but not NSAIDs, inhibit wound healing. Cataract surgery using limbal incisions and postoperative topical NSAIDs may result in faster wound healing and provide a reduced risk of related postoperative complications.
使用组织学标准研究局部应用甾体或非甾体抗炎药(NSAIDs)对角膜和角膜缘切口伤口愈合的影响。
美国伊利诺伊州梅伍德市洛约拉大学医学中心。
9只猫的18只眼睛用于该研究。所有右眼接受颞侧角膜缘切口,左眼接受透明角膜切口。所有眼睛术后用0.3%氧氟沙星治疗3天。动物被平均分为3组。第1组最多接受局部类固醇滴眼液(1%醋酸泼尼松龙)治疗7天;第2组最多接受局部NSAID滴眼液(0.5%酮咯酸氨丁三醇)治疗7天;第3组不接受额外治疗。每组一只动物在术后3、7或28天处死并摘除眼球。对眼睛进行苏木精-伊红和平滑肌肌动蛋白染色处理,角膜切片由眼科病理学家以盲法进行评估。
术后3天和7天,(1)角膜缘切口比同样处理的透明角膜切口表现出更显著的伤口愈合,(2)类固醇治疗的角膜伤口愈合比未治疗或NSAID治疗的角膜少。在28天时,所有眼睛的伤口几乎完全愈合。
角膜缘切口比透明角膜切口愈合更快。类固醇会抑制伤口愈合,而非甾体抗炎药不会。采用角膜缘切口和术后局部应用NSAIDs的白内障手术可能会使伤口愈合更快,并降低相关术后并发症的风险。