Kraff M C, Sanders D R, McGuigan L, Raanan M G
JFK Eye Institute, Chicago, IL 60634.
Arch Ophthalmol. 1990 Mar;108(3):380-3. doi: 10.1001/archopht.1990.01070050078035.
Various doses of a new topical nonsteroidal anti-inflammatory agent, diclofenac sodium, were tested against prednisolone sodium phosphate in a randomized double-masked study to determine comparative efficacy and safety regarding the reduction of postsurgical ocular inflammation. Inflammation was assessed by measuring fluorescein leakage into the anterior chamber using fluorophotometry techniques. Increased leakage in each patient's operated-on eye compared with the unoperated-on control eye was attributed to a breakdown in the blood-aqueous barrier caused by the cataract surgery. Elimination or significant reduction of fluorescein leakage within a treatment group constituted increased efficacy in controlling inflammation. A total of 124 cases were analyzed. There were no preoperative differences among groups in fluorescein leakage. At 1 week after surgery, all three diclofenac groups had significantly less fluorescein leakage compared with the prednisolone group. Mean percent increases were 56% to 118% in diclofenac groups vs 324% in the prednisolone group. No differences among diclofenac concentrations were detected. The differences between prednisolone and diclofenac were also present, although of lesser magnitude, at 3 weeks. This demonstration of increased efficacy of the nonsteroidal anti-inflammatory agent vs prednisolone is promising given the known side effects of ocular steroids.
在一项随机双盲研究中，针对磷酸泼尼松龙钠测试了不同剂量的新型局部非甾体抗炎药双氯芬酸钠，以确定在减轻术后眼部炎症方面的相对疗效和安全性。通过使用荧光光度法测量荧光素向前房内的渗漏来评估炎症。与未手术的对照眼相比，每位患者手术眼的渗漏增加归因于白内障手术导致的血-房水屏障破坏。治疗组内荧光素渗漏的消除或显著减少构成了控制炎症方面疗效的提高。总共分析了124例病例。术前各组在荧光素渗漏方面无差异。术后1周，与泼尼松龙组相比，所有三个双氯芬酸钠组的荧光素渗漏均显著减少。双氯芬酸钠组的平均增加百分比为56%至118%，而泼尼松龙组为324%。未检测到双氯芬酸钠浓度之间的差异。在3周时，泼尼松龙和双氯芬酸钠之间的差异也存在，尽管程度较小。鉴于眼部类固醇已知的副作用，这种非甾体抗炎药比泼尼松龙疗效更高的证明很有前景。
