Chaudhary K P, Sofat B K
Department of Ophthalmology, Indira Gandhi Medical College, Shimla.
Indian J Ophthalmol. 1992 Oct-Dec;40(4):109-14.
Induction of intraoperative pupillary constriction, is predominantly a prostaglandin mediated process. The most potent antiprostaglandin NSAID, Flurbiprofen was used topically to study its efficacy against the above. In a prospective double blind clinical study, 50 brown eyes undergoing planned E.C.C.E., the pupils were dilated with 10% phenylephrine and 2% homatropine 1%/tropicamide. 25 eyes received 0.03% Flurbiprofen-Na+ eye drops 1/2 hourly starting two hours before surgery. The maintained intraoperative mydriasis in the two groups before anterior chamber entry (stage I) vs at the end of complete cortex wash (stage III) was: in control group (stage I) 8.46 +/- 0.48 mm vs (stage III) 3.56 +/- 0.43 mm (highly SS); in flurbiprofen group (stage I) 8.60 +/- 0.48 mm vs (stage III) 8.01 +/- 0.63 mm (NSS). The pupillary area available for surgical manipulation in the control group was significantly decreased from 56.18 mm2 in state I to 9.94 mm2 in stage III, while in flurbiprofen group it changed insignificantly from 58.05 mm2 in stage I to 50.24 mm2 in stage III. Postoperatively after cataract was observed in 44% eyes of control group as compared to only 8% of eyes of flurbiprofen group. Thus a maintained intraoperative mydriasis in flurbiprofen group led to better E.C.L.E. which is a mandatory prerequisite to preferred and better present day posterior chamber IOL implantation.
术中瞳孔收缩的诱导主要是一个前列腺素介导的过程。最有效的抗前列腺素非甾体抗炎药氟比洛芬被局部用于研究其对上述情况的疗效。在一项前瞻性双盲临床研究中，50只棕色眼睛接受计划性白内障囊外摘除术（E.C.C.E.），用10%去氧肾上腺素和2%后马托品1%/托吡卡胺散瞳。25只眼睛在手术前两小时开始每半小时滴入0.03%氟比洛芬钠眼药水。两组在前房进入前（I期）与完全皮质冲洗结束时（III期）维持的术中瞳孔散大情况为：对照组（I期）8.46±0.48毫米 vs （III期）3.56±0.43毫米（高度显著差异）；氟比洛芬组（I期）8.60±0.48毫米 vs （III期）8.01±0.63毫米（无显著差异）。对照组可用于手术操作的瞳孔面积从I期的56.18平方毫米显著降至III期的9.94平方毫米，而氟比洛芬组从I期的58.05平方毫米至III期的50.24平方毫米变化不显著。对照组44%的眼睛术后出现白内障，而氟比洛芬组仅8%的眼睛出现。因此，氟比洛芬组术中维持的瞳孔散大导致更好的白内障囊外摘除术（E.C.L.E.），这是当今理想且更好的后房型人工晶状体植入的必要前提。
