Chang W, Chung M
Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea.
Eur J Ophthalmol. 2007 Sep-Oct;17(5):776-9. doi: 10.1177/112067210701700514.
To investigate the efficacy of anterior chamber paracentesis for intravitreal triamcinolone acetonide injection (IVTA).
A prospective, randomized clinical trial was conducted on 30 eyes from 30 patients scheduled for IVTA (4 mg/0.1 mL). Eyes were randomly divided into two groups: eyes that had undergone anterior chamber paracentesis (Group 1, 15 eyes) and eyes that did not have anterior chamber paracentesis (Group 2, 15 eyes). Intraocular pressure (IOP) was measured by Goldmann applanation tonometry at a baseline of 2, 15, 30, and 60 minutes at 1 day and 1 week after the injection. The authors analyzed the short-term postoperative changes of the IOP in each group.
For Group 1, the mean preoperative IOP was 15.33+/-1.72 mmHg, and the postoperative IOP at 2 and 15 minutes were 7.80+/-1.47 and 11.73+/-1.67 mmHg, respectively. For Group 2, there was a significant elevation of IOP (46.73+/-8.26 mmHg) 2 minutes after the injection, which decreased to the normal range (16.13+/-2.61 mmHg) by 15 minutes after the injection. There were no significant differences between the two groups in IOP at 15 minutes postsurgery compared with the distinct difference in IOP at 2 minutes post surgery (Student t-test, p=0.01).
The findings suggest that routine anterior chamber paracentesis is inappropriate due to the brief immediate postoperative IOP elevation with IVTA.
探讨前房穿刺术在玻璃体内注射曲安奈德(IVTA)中的疗效。
对30例计划接受IVTA(4mg/0.1mL)的患者的30只眼进行了一项前瞻性随机临床试验。将眼睛随机分为两组:接受前房穿刺术的眼睛(第1组,15只眼)和未接受前房穿刺术的眼睛(第2组,15只眼)。在注射后1天和1周的基线以及2、15、30和60分钟时,通过Goldmann压平眼压计测量眼压。作者分析了每组术后眼压的短期变化。
第1组术前平均眼压为15.33±1.72mmHg,术后2分钟和15分钟的眼压分别为7.80±1.47mmHg和11.73±1.67mmHg。第2组在注射后2分钟眼压显著升高(46.73±8.26mmHg),在注射后15分钟降至正常范围(16.13±2.61mmHg)。与术后2分钟眼压的明显差异相比,两组术后15分钟眼压无显著差异(Student t检验,p=0.01)。
研究结果表明,由于IVTA术后眼压短暂立即升高,常规前房穿刺术不合适。