Yeh Patrick C, Ramanathan Saras
Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois 60637, USA.
J Cataract Refract Surg. 2002 Oct;28(10):1814-8. doi: 10.1016/s0886-3350(02)01334-2.
To elucidate an association between latanoprost and clinically significant cystoid macular edema (CME) in patients after uneventful phacoemulsification with intraocular lens implantation.
Bergman Eye Center, Department of Ophthalmology, The University of Chicago Hospitals, Chicago, Illinois, USA.
One hundred forty-five consecutive patients (162 eyes) who had phacoemulsification from July 1999 to December 2000 were retrospectively reviewed to determine which patients developed CME. Patients with a history of inflammation and pseudoexfoliation, previous intraocular procedures, or current intraoperative complications were excluded from the study. All cases of CME were diagnosed on the basis of a fundus examination showing typical CME accompanied by a decrease in visual acuity. Upon diagnosis, latanoprost was discontinued and ketorolac was prescribed. The data were analyzed using the Fisher exact test. Of the records reviewed, 134 patients (151 eyes) were included in the study; 11 eyes were excluded secondary to intraoperative complications, a history of ocular inflammation, or both. Among the patients included, 12 were receiving latanoprost preoperatively.
Four cases of CME were identified; all 4 patients were taking latanoprost. Latanoprost was discontinued in 8 patients 1 week preoperatively, and none of them developed CME. Therefore, in this series, only patients receiving latanoprost developed CME after uneventful cataract surgery. This difference was statistically significant. In addition, all cases of CME resolved upon discontinuation of latanoprost and administration of ketorolac.
his retrospective study shows a clinical association between latanoprost use and postoperative CME after uneventful phacoemulsification. Given the absence of other coexisting risk factors for CME, this series suggests latanoprost is a significant etiologic factor for the development of postoperative CME.
阐明在白内障超声乳化联合人工晶状体植入术后无并发症的患者中，拉坦前列素与具有临床意义的黄斑囊样水肿（CME）之间的关联。
美国伊利诺伊州芝加哥市芝加哥大学医院眼科伯格曼眼科中心。
回顾性分析1999年7月至2000年12月连续接受白内障超声乳化手术的145例患者（162只眼），以确定哪些患者发生了CME。有炎症和假性剥脱病史、既往眼内手术史或当前术中并发症的患者被排除在研究之外。所有CME病例均根据眼底检查诊断，表现为典型的CME并伴有视力下降。确诊后，停用拉坦前列素并开具酮咯酸。采用Fisher精确检验分析数据。在审查的记录中，134例患者（151只眼）纳入研究；11只眼因术中并发症、眼部炎症病史或两者兼有而被排除。在纳入的患者中，12例术前正在使用拉坦前列素。
确定了4例CME；所有4例患者均在使用拉坦前列素。8例患者在术前1周停用拉坦前列素，无一例发生CME。因此，在本系列中，只有使用拉坦前列素的患者在无并发症的白内障手术后发生了CME。这种差异具有统计学意义。此外，所有CME病例在停用拉坦前列素并给予酮咯酸后均得到缓解。
这项回顾性研究表明，在白内障超声乳化术后无并发症的情况下，使用拉坦前列素与术后CME之间存在临床关联。鉴于不存在其他CME并存的危险因素，本系列研究表明拉坦前列素是术后CME发生的一个重要病因。
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