Kawahara Atsushi, Utsunomiya Tsugiaki, Kato Yuji, Takayanagi Yoshinori
Department of Ophthalmology, Sapporo Tokushukai Hospital, Sapporo, Hokkaido, Japan; Sapporo Kato Eye Clinic, Sapporo, Hokkaido, Japan; Takayanagi Clinic, Kushiro, Hokkaido, Japan.
Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Clin Ophthalmol. 2016 Mar 4;10:385-91. doi: 10.2147/OPTH.S101836. eCollection 2016.
The aim of this study was to compare the effects of nepafenac ophthalmic suspension 0.1% (Nevanac) and diclofenac sodium ophthalmic solution 0.1% (Diclod) on the cornea, tear film, and ocular surface after cataract surgery.
A total of 60 eyes (60 patients) were selected for this study, with no ocular diseases other than cataract (scheduled for cataract surgery by one surgeon). Patients were randomly enrolled to receive nepafenac or diclofenac in the perioperative period, and cataract surgery was performed using torsional microcoaxial phacoemulsification and aspiration with intraocular lens implantation via a transconjunctival single-plane sclerocorneal incision at the 12 o'clock position. We compared intra- and intergroup differences preoperatively and postoperatively in conjunctival and corneal fluorescein staining scores, tear film breakup times, Schirmer's tests, the Dry Eye Related Quality of Life Scores, and tear meniscus areas using anterior segment optical coherence tomography.
The diclofenac group had significantly higher conjunctival and corneal fluorescein staining scores at 4 weeks postoperatively compared with the nepafenac group (P<0.001). Within the diclofenac group, significantly higher conjunctival and corneal fluorescein staining scores were noted at 4 weeks postoperatively than those seen preoperatively (P<0.001) and at 1 week postoperatively (P<0.001). No statistically significant differences were found in any other items.
Nepafenac ophthalmic suspension 0.1% is considered safe for the corneal epithelium after cataract surgery.
本研究旨在比较0.1%萘哌地尔眼用混悬液（奈凡诺）和0.1%双氯芬酸钠滴眼液（迪可罗）在白内障手术后对角膜、泪膜和眼表的影响。
本研究共纳入60只眼（60例患者），除白内障外无其他眼部疾病（均由同一位外科医生安排进行白内障手术）。患者在围手术期被随机分组，分别接受萘哌地尔或双氯芬酸钠治疗，白内障手术采用扭转微同轴超声乳化吸除术，并通过12点位的经结膜单平面巩膜角膜切口植入人工晶状体。我们使用眼前节光学相干断层扫描比较术前和术后组内及组间在结膜和角膜荧光素染色评分、泪膜破裂时间、泪液分泌试验、干眼相关生活质量评分以及泪河面积方面的差异。
与萘哌地尔组相比，双氯芬酸钠组术后4周时结膜和角膜荧光素染色评分显著更高（P<0.001）。在双氯芬酸钠组内，术后4周时结膜和角膜荧光素染色评分显著高于术前（P<0.001）及术后1周时（P<0.001）。在其他任何项目中均未发现统计学上的显著差异。
0.1%萘哌地尔眼用混悬液被认为对白内障手术后的角膜上皮是安全的。
