Yılmaz Uğur, Küçük Erkut, Ulusoy Döndü Melek, Özköse Ayşe, Ataş Mustafa, Demircan Süleyman, Yuvacı Isa
a Niğde State Hospital , Nigde , Turkey and.
b Kayseri Training and Research Hospital , Kayseri , Turkey.
Cutan Ocul Toxicol. 2016 Mar;35(1):58-61. doi: 10.3109/15569527.2015.1017579. Epub 2015 Mar 23.
The purpose of our study is to assess the changes in macular thickness (MT) in diabetic and non-diabetic patients and to research effects of topical ketorolac (Acular®, Allergan, Irvine, CA) on MT change after neodymium:yttrium aluminum garnet (Nd:YAG) laser capsulotomy.
This study involved 88 eyes of 88 patients diagnosed as posterior capsule opacification (PCO). Patients were divided into four groups according to presence of diabetes mellitus (DM) and drugs used after capsulotomy. Group 1: Patients with DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy (22 patients). Group 2: Patients with DM using 0.5% ketorolac (Acular®) and 0.1 Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy (20 patients). Group 3: Patients without DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (22 patients). Group 4: Patients without DM using 0.5% ketorolac (Acular®) and 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (24 patients). A plus-shaped capsulotomy was performed using VISULAS® YAGIII (Carl Zeiss) laser microscope. MT measurement with Cirrus SD-OCT (Carl Zeiss Opthalmic System Inc., Model 400, Dublin, CA, Software 5) were done. Measurements were done before laser, and on the first day, first week, first month, third month and sixth month after laser capsulotomy. We compared the four groups for MT change during 6 months.
Group 1 involving patients with DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy had increased MT at the first week, and the first, third, and sixth month after laser (p < 0.001). Group 3 involving patients without DM using only 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) had increased MT at the first week, and at the first and third month, there was no statistically significant difference at the sixth month (p > 0.05). There was no statistically significant increase in MT during the follow-up period in group 2 involving patients with DM using 0.5% ketorolac (Acular®) and 0.1 Fluorometholon (FML®, Allergan, Irvine, CA) after capsulotomy and group 4 involving patients without DM using 0.5% ketorolac (Acular®) and 0.1% Fluorometholon (FML®, Allergan, Irvine, CA) (p > 0.05).
An increase in MT can be observed after Nd:YAG laser capsulotomy, especially in diabetic patients. Adding topical ketorolac (Acular®, Allergan, Irvine, CA) to topical Fluorometholon (FML®, Allergan, Irvine, CA) therapy after YAG laser capsulotomy can prevent this increase.
本研究旨在评估糖尿病患者和非糖尿病患者黄斑厚度（MT）的变化，并研究局部使用酮咯酸（爱尔康公司生产的阿乐迈，Irvine，加利福尼亚州）对钕：钇铝石榴石（Nd：YAG）激光晶状体囊切开术后MT变化的影响。
本研究纳入88例诊断为后囊膜混浊（PCO）的患者的88只眼。根据糖尿病（DM）的存在情况和囊切开术后使用的药物，将患者分为四组。第1组：囊切开术后仅使用0.1%氟米龙（爱尔康公司生产的氟美瞳，Irvine，加利福尼亚州）的糖尿病患者（22例）。第2组：囊切开术后使用0.5%酮咯酸（阿乐迈）和0.1%氟米龙（氟美瞳）的糖尿病患者（20例）。第3组：囊切开术后仅使用0.1%氟米龙（氟美瞳）的非糖尿病患者（22例）。第4组：囊切开术后使用0.5%酮咯酸（阿乐迈）和0.1%氟米龙（氟美瞳）的非糖尿病患者（24例）。使用VISULAS® YAGIII（卡尔蔡司）激光显微镜进行十字形囊切开术。采用Cirrus SD-OCT（卡尔蔡司眼科系统公司，型号400，都柏林，加利福尼亚州，软件5）测量MT。在激光治疗前、激光晶状体囊切开术后第1天、第1周、第1个月、第3个月和第6个月进行测量。我们比较了四组在6个月内的MT变化。
第1组囊切开术后仅使用0.1%氟米龙（氟美瞳）的糖尿病患者在激光治疗后的第1周、第1个月、第3个月和第6个月MT增加（p < 0.001）。第3组囊切开术后仅使用0.1%氟米龙（氟美瞳）的非糖尿病患者在第1周MT增加，在第1个月和第3个月增加，在第6个月无统计学显著差异（p > 0.05）。第2组囊切开术后使用0.5%酮咯酸（阿乐迈）和0.1%氟米龙（氟美瞳）的糖尿病患者和第4组囊切开术后使用0.5%酮咯酸（阿乐迈）和0.1%氟米龙（氟美瞳）的非糖尿病患者在随访期间MT无统计学显著增加（p > 0.05）。
Nd：YAG激光晶状体囊切开术后可观察到MT增加，尤其是糖尿病患者。YAG激光晶状体囊切开术后在局部使用氟米龙（氟美瞳）治疗中添加局部使用酮咯酸（阿乐迈）可预防这种增加。
