Mańkowska Anna, Rejdak Robert, Oleszczuk Agnieszka, Kiczyńska Magdalena, Łekawa Anna, Choragiewicz Tomasz, Zagórski Zbigniew
Katedra i Klinika Okulistyki Akademii Medycznej w Lublinie.
Klin Oczna. 2008;110(4-6):151-4.
To prospectively evaluate the effect on postoperative inflammatory reaction and recovery after application of triamcinolone acetonide (TA) during pars plana vitrectomy (PPV), to visualize the vitreous.
Pars plana vitrectomy (PPV) was performed in 45 patients (21 males, 24 females) (29 with retinal detachment, 6 with macular hole, 1 with cystoid macular edema, 3 with diabetic retinopathy, 3 with vitreous haemorrhage, 1 with preretinal membrane, 1 with PVR and 1 with lens luxation). After surgical separation of the posterior vitreous and removal of any visible epiretinal membrane, TA was injected over the posterior pole. For the control group we used 15 patients (10 with retinal detachment, 2 with macular hole, 1 with preretinal membrane, 1 with lens luxation and 1 with vitreous haemorrhage) (10 males, 5 females) treated with PPV but without TA administration. To evaluate the degree of postoperative inflammation and to monitor the dynamics of the blood-aqueous barrier disruption, the laser flare cell meter (Kowa FM-500) was used.
Tyndalometric mean values in the control group of eyes recorded 1 day after PPV were 32.41 +/- 6.1 ph/ msec while values in TA-treated group were significantly lower (20.26 +/- 2.4, p < 0.02). 10 days after surgery in TA group results were still significantly lower as compared to the control group (16.4 +/- 2.6 vs 32.5 +/- 9.6, p < 0.005). As observed 6 weeks after PPV, tyndalometric recordings in TA-treated group remained lower as those observed in the control group (16.1 +/- 3.1 vs 32.0 +/- 8.1, p < 0.01).
The eyes which received TA-assisted PPV showed significantly less breakdown of the blood-ocular barrier than those with routine PPV. Intraoperative administration TA facilitates postoperative recovery after surgery lowering the inflammatory reaction.
前瞻性评估曲安奈德（TA）在玻璃体切割术（PPV）中应用对术后炎症反应及恢复的影响，并观察玻璃体情况。
对45例患者（男21例，女24例）行玻璃体切割术（29例视网膜脱离，6例黄斑裂孔，1例黄斑囊样水肿，3例糖尿病性视网膜病变，3例玻璃体积血，1例视网膜前膜，1例增殖性玻璃体视网膜病变，1例晶状体脱位）。在手术分离玻璃体后皮质并清除可见的视网膜前膜后，于后极部注射TA。对照组为15例患者（男10例，女5例）（10例视网膜脱离，2例黄斑裂孔，1例视网膜前膜，1例晶状体脱位，1例玻璃体积血），接受玻璃体切割术但未注射TA。使用激光散射细胞仪（Kowa FM - 500）评估术后炎症程度并监测血 - 房水屏障破坏的动态变化。
PPV术后1天，对照组眼的散射光测量平均值为32.41±6.1ph/msec，而TA治疗组的值显著更低（20.26±2.4，p<0.02）。TA组术后10天的结果与对照组相比仍显著更低（16.4±2.6对32.5±9.6，p<0.005）。PPV术后6周观察发现，TA治疗组的散射光测量记录仍低于对照组（16.1±3.1对32.0±8.1，p<0.01）。
接受TA辅助PPV的眼比常规PPV的眼血 - 眼屏障破坏明显更少。术中应用TA可降低炎症反应，促进术后恢复。
