Caça Ihsan, Sahin Alparslan, Cingü Abdullah Kürsat, Ari Seyhmus, Alakuş Fuat, Cinar Yasin
Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakır, Turkey.
Int J Ophthalmol. 2012;5(5):596-9. doi: 10.3980/j.issn.2222-3959.2012.05.10. Epub 2012 Oct 18.
To assess the efficacy of intracameral enoxaparin (a low-molecular-weight heparin) infusion, in variable doses on postoperative inflammatory response in congenital cataract surgery.
It is a prospective, randomized controlled trial. Eighty eyes of 53 children with congenital cataract were enrolled in this study. Every eye had primary posterior capsulorrhexis and intraocular lens (IOL) implantation after lens aspiration. The eyes were divided into 4 equal groups. In group 1 balanced salt solution (BSS) without enoxaparin was used as an irrigation solution. Whereas in group 2, 3 and 4, 40mg, 20mg and 10mg enoxaparin in 500mL BSS was used respectively. The inflammatory response in the anterior chamber was compared among the groups with slit-lamp biomicroscopy.
The mean follow-up period was (17.75±3.95) months in group 1, (18.00±5.15) months in group 2, (19.20±5.47) months in group 3 and (18.65±5.16) months in group 4. Mean number of inflammatory cells in the anterior chamber in group 1 was significantly higher than that of group 2, 3, 4 (P<0.001). There was fibrin formation in the anterior chambers of 3 eyes in group 1 and one eye in group 4. There was synechiae formation in 3 eyes of group 1 and one eye of group 4. There was no significant difference among the groups by means of fibrin or synechiae formation (P>0.05). There were IOL precipitates in 4 eyes of group 1 and 2 eyes of group 4. IOL precipitate formation was significantly higher in group 1 than that of group 2 and 3 in which there was no IOL precipitate (P=0.048). There was IOL subluxation in only one eye of group 1, 3 and 4 while no subluxation was observed in group 2 (P>0.05). There was no statistically significant difference detected about IOL subluxation occurance in all 4 groups (P>0.05).
Complications of cataract surgery in congenital cataract patients associated with postoperative inflammatory response found to be decreased with the use of enoxaparin in intraocular infusion solutions. Furthermore according to our results the anti-inflammatory effect of enoxaparin was dose dependant.
评估前房内注射不同剂量依诺肝素（一种低分子肝素）对先天性白内障手术术后炎症反应的疗效。
这是一项前瞻性随机对照试验。本研究纳入了53例患有先天性白内障儿童的80只眼。每只眼在晶状体吸出术后均进行了一期后囊撕开和人工晶状体（IOL）植入。将这些眼分为4组，每组20只眼。第1组使用不含依诺肝素的平衡盐溶液（BSS）作为冲洗液。而在第2、3和4组中，分别在500mL BSS中加入40mg、20mg和10mg依诺肝素。通过裂隙灯生物显微镜检查比较各组前房内的炎症反应。
第1组的平均随访时间为（17.75±3.95）个月，第2组为（18.00±5.15）个月，第3组为（19.20±5.47）个月，第4组为（18.65±5.16）个月。第1组前房内炎症细胞的平均数量显著高于第2、3、4组（P<0.001）。第1组有3只眼和第4组有1只眼前房内有纤维蛋白形成。第1组有3只眼和第4组有1只眼前房有粘连形成。各组间纤维蛋白或粘连形成情况无显著差异（P>0.05）。第1组有4只眼和第4组有2只眼出现人工晶状体沉淀。第1组人工晶状体沉淀的形成显著高于第2组和第3组，第2组和第3组无人工晶状体沉淀（P=0.048）。第1、3和4组各有1只眼出现人工晶状体半脱位，而第2组未观察到半脱位（P>0.05）。4组人工晶状体半脱位发生率无统计学显著差异（P>0.05）。
发现先天性白内障患者白内障手术中与术后炎症反应相关的并发症，可通过在眼内输注溶液中使用依诺肝素而减少。此外，根据我们的结果，依诺肝素的抗炎作用是剂量依赖性的。
