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术中单次Tenon囊下注射曲安奈德对白内障手术后糖尿病视网膜病变进展及视觉预后的影响。

Effect of a single intraoperative sub-Tenon injection of triamcinolone acetonide on the progression of diabetic retinopathy and visual outcomes after cataract surgery.

作者信息

Kim Su-Young, Yang Jiwook, Lee Young-Chun, Park Young-Hoon

机构信息

Department of Ophthalmology and Visual Science, College of Medicine, Catholic University of Korea, Seoul, Korea.

出版信息

J Cataract Refract Surg. 2008 May;34(5):823-6. doi: 10.1016/j.jcrs.2008.01.018.

Abstract

PURPOSE

To assess the effect of a single intraoperative sub-Tenon injection of triamcinolone acetonide on the progression of diabetic retinopathy (DR), visual outcomes, and cystoid macular edema (CME) after cataract surgery.

SETTING

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.

METHODS

This prospective controlled study comprised 46 eyes of 23 diabetic patients. The control group comprised eyes not treated with a triamcinolone acetonide injection, and the triamcinolone group comprised contralateral eyes treated with a single posterior sub-Tenon injection of triamcinolone acetonide at the end of cataract surgery. The visual acuity, central macular thickness (CMT) by optical coherence tomography, and progression of DR were compared between the 2 groups.

RESULTS

One month postoperatively, the mean change in lines of best corrected visual acuity was significantly greater in the triamcinolone group (P = .045) and the mean change in CMT was significantly greater in the control group (P = .015). The incidence of CME was higher in the control group (P = 0.04). Scores for progression of DR at 6 months were not statistically significantly different between the 2 groups (P = 0.08).

CONCLUSIONS

A posterior sub-Tenon injection of triamcinolone acetonide lowered the incidence of CME after cataract surgery in diabetic patients, improved visual recovery, and reduced the amount of CMT increase in the short term (< or = 1 month postoperatively). However, triamcinolone acetonide did not affect DR progression over the 6-month follow-up.

摘要

目的

评估术中单次球后注射曲安奈德对糖尿病视网膜病变(DR)进展、白内障手术后视力预后及黄斑囊样水肿(CME)的影响。

设置

韩国首尔天主教大学医学院眼科与视觉科学系。

方法

这项前瞻性对照研究纳入了23例糖尿病患者的46只眼。对照组为未接受曲安奈德注射治疗的眼,曲安奈德组为白内障手术结束时接受单次球后注射曲安奈德的对侧眼。比较两组的视力、光学相干断层扫描测量的中心黄斑厚度(CMT)以及DR的进展情况。

结果

术后1个月,曲安奈德组最佳矫正视力的平均行数变化显著更大(P = 0.045),而CMT的平均变化在对照组中显著更大(P = 0.015)。对照组CME的发生率更高(P = 0.04)。两组在6个月时DR进展的评分差异无统计学意义(P = 0.08)。

结论

球后注射曲安奈德可降低糖尿病患者白内障手术后CME的发生率,改善视力恢复,并在短期内(术后≤1个月)减少CMT增加量。然而,在6个月的随访中,曲安奈德对DR进展无影响。

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