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萘非那酸对接受白内障超声乳化术的青光眼患者黄斑区形态的影响。

Effect of nepafenac on the foveal profile of glaucomatous patients undergoing phacoemulsification.

作者信息

Milla Elena, Stirbu Oana, Franco Isabel Jimenez, Hernández Santiago J García, Rios Jose, Duch Susana

机构信息

Glaucoma Unit, Ophthalmology Department, Hospital Clínic de Barcelona, Sabino Arana, 1, 08028, Barcelona, Spain.

Glaucoma Unit, Institut Comtal d'Oftalmologia, Barcelona, Spain.

出版信息

Int Ophthalmol. 2017 Oct;37(5):1147-1153. doi: 10.1007/s10792-016-0381-6. Epub 2016 Oct 22.

Abstract

PURPOSE

Retrospective, pilot study to determine whether nepafenac treatment pre- and postcataract surgery in glaucoma patients using topical hypotensive agents minimized cystoid macular edema by comparing pre- and postsurgical foveal characteristics, as in some cases these agents cannot be withdrawn and, hypothetically, their inflammatory effect on the fovea could be neutralized by the addition of nepafenac.

METHODS

Patients were divided into two subgroups depending on whether or not topical nepafenac was added to the surgical protocol (NEP = nepafenac group and nNEP = non nepafenac group). All had undergone phacoemulsification and data on pre- and postoperative macular status were recorded.

RESULTS

In the nNEP group, there was a significant increase in foveal thickness (FT) in the first month postoperative visit with respect to the preoperative status (p = 0.006), and this situation did not change at the third postoperative month (p = 0.9411). In the NEP group, the increase in FT was not significant at the first month after surgery (p = 0.056) nor at the final visit (p = 0.268), in contrast to the nNEP group.

CONCLUSION

This study of the possible prophylactic effect of nepafenac on postoperative macular edema supports the results of other studies that confirm subclinical edema post phacoemulsification, and found a significantly lower gradient in the increase in FT in patients treated pre- and postoperatively with nepafenac.

摘要

目的

进行一项回顾性试点研究,通过比较白内障手术前后的黄斑中心凹特征,来确定在使用局部降压药物的青光眼患者白内障手术前后使用奈帕芬酸治疗是否能将黄斑囊样水肿降至最低。因为在某些情况下,这些药物不能停用,并且据推测,添加奈帕芬酸可中和其对黄斑中心凹的炎症作用。

方法

根据手术方案中是否添加局部用奈帕芬酸,将患者分为两个亚组(NEP = 奈帕芬酸组和nNEP = 非奈帕芬酸组)。所有患者均接受了超声乳化手术,并记录了术前和术后黄斑状态的数据。

结果

在nNEP组中,术后第一个月黄斑中心凹厚度(FT)相对于术前状态有显著增加(p = 0.006),且在术后第三个月这种情况没有变化(p = 0.9411)。与nNEP组相比,在NEP组中,术后第一个月FT的增加不显著(p = 0.056),在最后一次随访时也不显著(p = 0.268)。

结论

这项关于奈帕芬酸对术后黄斑水肿可能的预防作用的研究支持了其他研究的结果,这些研究证实了超声乳化术后存在亚临床水肿,并发现术前和术后使用奈帕芬酸治疗的患者FT增加的梯度显著更低。

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