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白内障合并糖尿病性黄斑水肿患者的超声乳化手术与玻璃体内注射曲安奈德联合治疗

The combination of phacoemulsification surgery and intravitreal triamcinolone injection in patients with cataract and diabetic macular edema.

作者信息

Ozgur Ozlen Rodop, Ozkurt Yelda, Kulekci Zeynep, Evciman Tufan

机构信息

Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.

Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.

出版信息

Saudi J Ophthalmol. 2016 Jan-Mar;30(1):33-8. doi: 10.1016/j.sjopt.2015.10.004. Epub 2015 Oct 30.

Abstract

PURPOSE

To assess the safety and efficiency of combined phacoemulsification (PHACO) surgery and intravitreal triamcinolone (IVTA) injection with or without macular grid laser photocoagulation in patients with cataract and diabetic macular edema.

MATERIAL AND METHODS

This prospective study included 41 eyes of 36 diabetic patients with cataract and coexisting clinically significant macular edema (CSME). After PHACO and IVTA injection eyes were divided into two groups: the laser and IVTA group (Group 1) and only IVTA group (Group 2). Preoperative and postoperative best corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) were recorded. Paired sample t-test was used to compare data in the groups and C square test for qualitative variables.

RESULTS

Postoperative BCVA was significantly higher than the initial BCVA during the follow-up period in both groups (p < 0.01). The BCVA 6 months after surgery was significantly higher in group 1 than in group 2 (p < 0.01). There was no statistically significant difference in IOP between two groups preoperatively and postoperatively during the follow-up period (p > 0.05). There was no statistically significant difference between both groups in mean CMT preoperatively and 2nd week, 2nd month and 3rd month after surgery (p > 0.05). The mean CMT 6 months after surgery was statistically significantly lower in group 1 than in group 2 (p < 0.01).

CONCLUSIONS

PHACO surgery combined with IVTA injection improves BCVA and provides a decrease in CMT in diabetic patients with CSME. Additional macular grid laser photocoagulation after surgery helps to preserve this improvement in BCVA and decrease in CMT.

摘要

目的

评估白内障合并糖尿病性黄斑水肿患者行超声乳化白内障吸除术(PHACO)联合玻璃体内注射曲安奈德(IVTA),以及联合或不联合黄斑格栅激光光凝的安全性和有效性。

材料与方法

本前瞻性研究纳入了36例患有白内障且并存临床显著性黄斑水肿(CSME)的糖尿病患者的41只眼。在进行PHACO和IVTA注射后,将患眼分为两组:激光联合IVTA组(第1组)和单纯IVTA组(第2组)。记录术前和术后的最佳矫正视力(BCVA)、中心黄斑厚度(CMT)和眼压(IOP)。采用配对样本t检验比较两组数据,定性变量采用C²检验。

结果

在随访期间,两组患者术后BCVA均显著高于初始BCVA(p<0.01)。术后6个月,第1组的BCVA显著高于第2组(p<0.01)。随访期间,两组术前和术后的IOP无统计学显著差异(p>0.05)。两组术前、术后第2周、第2个月和第3个月的平均CMT无统计学显著差异(p>0.05)。术后6个月,第1组的平均CMT显著低于第2组(p<0.01)。

结论

PHACO手术联合IVTA注射可改善CSME糖尿病患者的BCVA并降低CMT。术后额外进行黄斑格栅激光光凝有助于维持BCVA的改善和CMT的降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a027/4759512/0b8659c7b7c4/gr1.jpg

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