Flach A J, Dolan B J
San Francisco Veterans Affairs Medical Center, USA.
Trans Am Ophthalmol Soc. 2000;98:101-5; discussion 105-7.
Laboratory studies in experimental animals suggest that use of nonsteroidal anti-inflammatory drugs decreases the incidence of posterior capsular opacification (PCO) following cataract surgery. Recently the incidence of PCO following cataract surgery and intraocular lens implantation was reported to be no different following postoperative treatment with diclofenac sodium 0.1% (Voltaren, Ciba Vision) or with dexamethasone 0.1% (Maxidex, Alcon). We studied the incidence of PCO in patients following treatment with diclofenac 0.1% and ketorolac tromethamine 0.5% (Acular, Allergan) ophthalmic solutions 3 years after cataract surgery and implantation of a foldable silicone intraocular lens.
A total of 120 patients underwent phacoemulsification and implantation of a foldable silicone intracular lens. Patients were treated with either diclofenac 0.1% ophthalmic solution or 0.5% ketorolac ophthalmic solution 4 times daily for 30 days in a double-masked, randomized fashion during the postoperative period. Patients were examined 3 years following surgery by a masked observer who determined which patients received YAG capsulotomies and graded any existing PCO.
Each treatment group had 12% YAG capsulotomies 3 years following surgery. Although PCO was present more often with diclofenac treatment (25/62) than with ketorolac treatment (16/58), this difference is not statistically significant (P = .142). Patients tolerated both treatments well without a difference in toxic effects or tolerability.
This study did not demonstrate a difference in the ability of diclofenac or ketorolac ophthalmic solutions to prevent PCO following cataract extraction and implantation of an intraocular lens. Both treatment regimens were equally well tolerated.
对实验动物的实验室研究表明,使用非甾体抗炎药可降低白内障手术后后囊膜混浊(PCO)的发生率。最近有报道称,白内障手术及人工晶状体植入术后,使用0.1%双氯芬酸钠(Voltaren,汽巴视力)或0.1%地塞米松(Maxidex,爱尔康)进行术后治疗,PCO的发生率并无差异。我们研究了白内障手术及植入可折叠硅胶人工晶状体3年后,使用0.1%双氯芬酸和0.5%酮咯酸氨丁三醇(Acular,爱尔康)眼药水治疗的患者中PCO的发生率。
共有120例患者接受了超声乳化白内障吸除术及可折叠硅胶人工晶状体植入术。术后期间,患者被随机双盲分为两组,分别每日4次使用0.1%双氯芬酸眼药水或0.5%酮咯酸眼药水,持续30天。术后3年,由一位不知情的观察者对患者进行检查,确定哪些患者接受了YAG激光后囊切开术,并对存在的PCO进行分级。
术后3年,每个治疗组均有12%的患者接受了YAG激光后囊切开术。虽然接受双氯芬酸治疗的患者中PCO的发生率(25/62)高于接受酮咯酸治疗的患者(16/58),但这种差异无统计学意义(P = 0.142)。两种治疗方法患者耐受性均良好,毒副作用及耐受性方面无差异。
本研究未显示双氯芬酸或酮咯酸眼药水在预防白内障摘除及人工晶状体植入术后PCO方面存在差异。两种治疗方案耐受性均良好。