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新型硅油/乙酰水杨酸混悬液用于增殖性玻璃体视网膜病变眼内填塞的安全性和可行性:奥地利临床多中心研究的初步结果。

Safety and feasibility of a novel intravitreal tamponade using a silicone oil/acetyl-salicylic acid suspension for proliferative vitreoretinopathy: first results of the Austrian Clinical Multicenter Study.

机构信息

Department of Ophthalmology, Innsbruck Medical University, Innsbruck, Austria.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2010 Aug;248(8):1193-8. doi: 10.1007/s00417-010-1389-7. Epub 2010 Apr 28.

Abstract

BACKGROUND

The safety and efficacy of a new surgical method of intravitreal tamponade using silicone oil suspended with aspirin (acetylsalicylic acid) was investigated for the treatment of proliferative vitreoretinopathy.

METHODS

The study was designed as a prospective, randomized, controlled, double-blind multicenter study. A total of 29 patients were included; 15 patients were treated with the silicone oil suspended with aspirin, and 14 patients represented the control group receiving only silicone oil. A standard three-port pars plana vitrectomy was performed in 29 eyes of 29 patients. In cases in which the natural lens was present, simultaneous phacoemulsification was required. The control group received as standard therapy a vitreous tamponade with pure 5000 mPas silicone oil and the treatment group received silicone oil containing 0.2 mg/ml aspirin (AS SiO). At 6 months after surgery, the tamponade was removed from all eyes. The main outcome measure was the incidence of retinal redetachment requiring reoperation. Secondary outcome measures were visual acuity and ophthalmic examination results.

RESULTS

The rate of redetachment, defined as the primary outcome parameter, was the same for both groups. The AS SiO was well tolerated and remained clear during the 6-month study period. Clinical examination revealed no signs of local or systemic adverse effects. The visual acuities were well matched before inclusion in the study and there were no significant differences during the follow-up period and in the final visual outcome between the two groups.

CONCLUSIONS

Aspirin delivery by intravitreal silicone oil in the human eye is safe and also may provide a delivery vehicle for other antiproliferative agents to the posterior pole.

摘要

背景

本研究旨在评估将阿司匹林(乙酰水杨酸)混悬于硅油中进行眼内填充作为一种新型眼内填充剂,以治疗增殖性玻璃体视网膜病变的安全性和有效性。

方法

本研究为前瞻性、随机、对照、双盲多中心研究。共纳入 29 例(29 只眼)患者,其中 15 例患者接受含阿司匹林(0.2mg/ml)硅油眼内填充治疗(实验组),14 例患者仅接受单纯硅油眼内填充治疗(对照组)。所有患者均行标准三通道经睫状体平坦部玻璃体切除术。如果晶状体存在,需同时行晶状体超声乳化术。对照组患者接受标准硅油玻璃体填充治疗(5000mPas 硅油),实验组患者接受含 0.2mg/ml 阿司匹林的硅油玻璃体填充治疗。术后 6 个月,所有患者均行硅油取出术。主要观察指标为视网膜再脱离的发生率。次要观察指标为视力和眼部检查结果。

结果

两组患者视网膜再脱离的发生率无显著差异,均为主要观察指标。实验组患者对含阿司匹林的硅油填充治疗有良好的耐受性,且在 6 个月的研究期间硅油均保持清晰。临床检查未发现局部或全身不良反应。两组患者治疗前视力相当,随访期间和最终视力结果无显著差异。

结论

将阿司匹林混悬于硅油中眼内填充是安全的,也可能为将其他抗增殖药物递送至眼后节提供一种载体。

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