Moghimi Sasan, Zandian Mehdi, Latifi Golshan, Amini Heydar, Eslami Yadollah, Zarei Reza, Fakhraie Ghasem, Nouri-Mahdavi Kouros
Farabi Eye Research Center, Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran.
J Ophthalmic Vis Res. 2012 Oct;7(4):289-94.
To explore changes in central macular thickness (CMT) after a two-month period of glaucoma therapy with topical latanoprost after uneventful phacoemulsification.
Forty-one eyes of 31 patients with primary open angle or pseudoexfoliative glaucoma who required glaucoma medications after cataract surgery were prospectively enrolled. All eyes had undergone uneventful phacoemulsification with intraocular lens implantation at least 4 months before initiation of latanoprost. After a complete ophthalmic examination, spectral-domain optical coherence tomography (SD-OCT) and fluorescein angiography (FA) were performed at baseline before starting latanoprost. All eyes received latanoprost for 2 months, and clinical examinations were repeated one and two months afterwards; OCT and FA were repeated after 2 months. Outcome measures were CMT and loss of more than 2 lines of best corrected visual acuity (BCVA).
Mean patient age was 71.6±7.8 years. Intraocular pressure decreased from 21.5±3.4 mmHg to 14.4±2.6 mmHg (p<0.001) at 2 months. None of the eyes developed reduction of BCVA exceeding 2 lines, or angiographic cystoid macular edema (CME). Likewise no significant change was noted in CMT (249.9±29.8 vs 248.8±30.7µm), average macular thickness (274.5±15.0 vs 273.8±17.0µm), or macular volume (9.6±1.0 vs 9.6±1.1µm2) after treatment as compared to baseline (P>0.05 for all comparisons).
Topical use of latanoprost later than 4 months after uncomplicated cataract surgery does not seem to predispose to increased macular thickness or CME and may safely be used in this setting.
探讨在白内障超声乳化手术顺利完成后，使用局部拉坦前列素进行为期两个月的青光眼治疗后，黄斑中心厚度（CMT）的变化情况。
前瞻性纳入31例原发性开角型或假性剥脱性青光眼患者的41只眼，这些患者在白内障手术后需要使用青光眼药物。所有眼睛在开始使用拉坦前列素前至少4个月均顺利接受了白内障超声乳化联合人工晶状体植入术。在进行全面的眼科检查后，于开始使用拉坦前列素前的基线期进行了光谱域光学相干断层扫描（SD - OCT）和荧光素血管造影（FA）。所有眼睛均接受拉坦前列素治疗2个月，之后在1个月和2个月时重复进行临床检查；2个月后重复进行OCT和FA检查。观察指标为CMT以及最佳矫正视力（BCVA）下降超过2行。
患者平均年龄为71.6±7.8岁。2个月时眼压从21.5±3.4 mmHg降至14.4±2.6 mmHg（p<0.001）。没有眼睛出现BCVA下降超过2行或血管造影显示的黄斑囊样水肿（CME）。同样，与基线相比，治疗后CMT（249.9±29.8 vs 248.8±30.7µm）、平均黄斑厚度（274.5±15.0 vs 273.8±17.0µm）或黄斑体积（9.6±1.0 vs 9.6±1.1µm²）均无显著变化（所有比较P>0.05）。
在无并发症的白内障手术后4个月以上局部使用拉坦前列素似乎不会导致黄斑厚度增加或CME，在此情况下可安全使用。
