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玻璃体切割术后单次后Tenon囊下注射曲安奈德与1%醋酸泼尼松龙滴眼液的抗炎效果比较

Anti-inflammatory efficacy of a single posterior subtenon injection of triamcinolone acetonide versus prednisolone acetate 1% eyedrops after pars plana vitrectomy.

作者信息

Paccola Letícia, Jorge Rodrigo, Barbosa José C, Costa Rogério A, Scott Ingrid U

机构信息

Department of Ophthalmology, School of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil.

出版信息

Acta Ophthalmol Scand. 2007 Sep;85(6):603-8. doi: 10.1111/j.1600-0420.2007.00923.x. Epub 2007 Apr 24.

Abstract

PURPOSE

To compare the safety and anti-inflammatory efficacy of a single posterior subtenon injection of triamcinolone acetonide (TA) with prednisolone acetate 1% eyedrops after pars plana vitrectomy (PPV).

METHODS

The study included 40 consecutive phakic eyes of 40 patients undergoing PPV for non-clearing vitreous haemorrhage with attached retina (verified by echography), epiretinal membrane or macular hole. At the end of the surgical procedure, eyes were randomized to receive either a single posterior subtenon injection of TA (40 mg in 1 ml) plus sham eyedrops (prednisolone acetate 1% vehicle) postoperatively (group TA), or a posterior subtenon sham injection (1 ml balanced salt solution) plus prednisolone acetate 1% eyedrops postoperatively (group ED).

RESULTS

There was no difference in the severity of anterior chamber cell and flare between the two groups at any time-point during the study period (p > 0.05). Separate within-group analysis revealed a significant decrease in anterior chamber cell and flare from postoperative day 1 to postoperative days 7, 14 and 28 in both groups (p < 0.05). There was no difference in pain, photophobia, conjunctival erythema, ciliary flush or chemosis scores between the two groups at any time-point during the study period (p > 0.05). Steroid-induced intraocular hypertension was not observed in either group.

CONCLUSIONS

A single posterior subtenon injection of TA can be as effective and safe as a 4-week regimen of prednisolone acetate 1% eyedrops in controlling intraocular inflammation after PPV.

摘要

目的

比较玻璃体切割术后单次后Tenon囊下注射曲安奈德(TA)与1%醋酸泼尼松龙滴眼液的安全性和抗炎效果。

方法

本研究纳入40例因玻璃体出血不吸收、视网膜附着(经超声检查证实)、视网膜前膜或黄斑裂孔而接受玻璃体切割术的40只连续的有晶状体眼。手术结束时,将眼睛随机分为两组,一组术后接受单次后Tenon囊下注射TA(1ml中含40mg)加安慰剂滴眼液(1%醋酸泼尼松龙赋形剂)(TA组),另一组术后接受后Tenon囊下安慰剂注射(1ml平衡盐溶液)加1%醋酸泼尼松龙滴眼液(ED组)。

结果

在研究期间的任何时间点,两组之间前房细胞和闪光的严重程度均无差异(p>0.05)。组内单独分析显示,两组在术后第1天至术后第7天、14天和28天,前房细胞和闪光均显著减少(p<0.05)。在研究期间的任何时间点,两组之间的疼痛、畏光、结膜充血、睫状充血或球结膜水肿评分均无差异(p>0.05)。两组均未观察到类固醇性青光眼。

结论

在控制玻璃体切割术后眼内炎症方面,单次后Tenon囊下注射TA与4周使用1%醋酸泼尼松龙滴眼液的方案同样有效且安全。

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