Agange Negin, Mosaed Sameh
Department of Ophthalmology, University of California, Irvine, CA 92697, USA.
J Ophthalmol. 2010;2010:690707. doi: 10.1155/2010/690707. Epub 2010 Nov 7.
To our knowledge, we are reporting the first case of a 59-year-old man who developed recurrent CME with three separate trials of three different prostaglandin class drugs following uncomplicated phacoemulsification with intraocular lens implantation. Despite multiple reports of individual prostaglandin (PG) analogues being suggested as the cause of CME, there are no recommendations regarding withholding these medications in the perioperative period. Our patient first developed CME OD 4-months post uncomplicated cataract extraction. XALATAN (Latanoprost) had been restarted after surgery and discontinued at onset of CME. While off XALATAN (Latanoprost), the patient's CME resolved, but his IOP rose. The patient was started on LUMIGAN (Bimatoprost) to control the IOP, but within weeks his CME recurred. The patient's CME was again treated and his IOP remained acceptable, but then progressively increased. TRAVATAN (Travoprost) was attempted, but he presented with a third round of CME. Definitive conclusions about causal relationships cannot be made without well-designed, prospective clinical trials addressing this issue.
据我们所知，我们报告了首例59岁男性患者，在白内障超声乳化联合人工晶状体植入术后未出现并发症的情况下，分别使用三种不同类别的前列腺素药物进行三次不同试验，均出现复发性囊膜黄斑水肿（CME）。尽管有多项报告指出个别前列腺素（PG）类似物被认为是CME的病因，但对于围手术期停用这些药物尚无相关建议。我们的患者在白内障摘除术后4个月首次出现右眼CME。术后重新开始使用适利达（拉坦前列素），CME发作时停药。停用适利达（拉坦前列素）后，患者的CME消退，但眼压升高。开始使用卢美根（比马前列素）控制眼压，但数周内CME复发。患者的CME再次得到治疗，眼压仍可接受，但随后逐渐升高。尝试使用苏为坦（曲伏前列素），但他出现了第三轮CME。如果没有针对此问题进行精心设计的前瞻性临床试验，就无法得出关于因果关系的确切结论。
