Diakonis Vasilios F, Kontadakis Georgios A, Anagnostopoulos Apostolos G, Yesilirmak Nilufer, Waren Daniel P, Cabot Florence, Yoo Sonia H, Donaldson Kendall E
J Refract Surg. 2017 Apr 1;33(4):230-234. doi: 10.3928/1081597X-20170111-02.
To assess pupil diameter before and after femtosecond laser-assisted capsulotomy in patients who were pretreated with a short-term topical nonsteroidal anti-inflammatory drug (NSAID) (ketorolac) versus those without pretreatment.
This prospective, randomized, observational case series included consecutive patients scheduled to undergo cataract extraction using the Catalys femtosecond laser platform (Abbott Medical Optics, Inc., Santa Ana, CA) to perform only capsulotomies. The same protocol for preoperative medical mydriasis was used for all patients, whereas pupil diameter was assessed using a surgical ruler immediately before and 3 minutes after femtosecond laser-assisted capsulotomy. The patients were divided into two groups: one received short-term topical ketorolac preoperatively and the other did not receive NSAID pretreatment (control).
A total of 42 eyes of 42 patients (1 eye per patient) were included in the study. Mean pupillary miosis was 0.79 ± 1.08 and 1.57 ± 1.19 mm for the ketorolac and control groups, respectively. There was a statistically significant decrease in pupil diameter for both groups individually (P < .05). There was also a statistically significant difference between the two groups (P < .05) with the induced miosis in the eyes that did not receive topical NSAIDs prior to cataract extraction being twofold greater when compared with the miosis of the eyes that received ketorolac pretreatment.
Short-term topical use of ketorolac prior to femtosecond laser-assisted cataract surgery seems to induce significantly less pupillary miosis in comparison to eyes that did not receive NSAID pretreatment. NSAID use is advised prior to femtosecond laser-assisted cataract surgery to minimize pupil miosis-related surgical difficulties or complications during cataract extraction. [J Refract Surg. 2017;33(4):230-234.].
评估短期局部使用非甾体抗炎药（NSAID）（酮咯酸）预处理的患者与未预处理的患者在飞秒激光辅助晶状体切开术前和术后的瞳孔直径。
本前瞻性、随机、观察性病例系列纳入了连续的计划使用Catalys飞秒激光平台（雅培医疗光学公司，加利福尼亚州圣安娜）仅进行晶状体切开术的白内障摘除患者。所有患者均采用相同的术前药物散瞳方案，而在飞秒激光辅助晶状体切开术前即刻和术后3分钟使用手术尺评估瞳孔直径。患者分为两组：一组术前短期局部使用酮咯酸，另一组未接受NSAID预处理（对照组）。
本研究共纳入42例患者的42只眼（每位患者1只眼）。酮咯酸组和对照组的平均瞳孔缩小分别为0.79±1.08和1.57±1.19mm。两组各自的瞳孔直径均有统计学显著下降（P<.05）。两组之间也存在统计学显著差异（P<.05），与接受酮咯酸预处理的眼睛相比，白内障摘除术前未局部使用NSAIDs的眼睛诱导的瞳孔缩小程度要大两倍。
与未接受NSAID预处理的眼睛相比，飞秒激光辅助白内障手术前短期局部使用酮咯酸似乎诱导的瞳孔缩小明显更少。建议在飞秒激光辅助白内障手术前使用NSAID，以尽量减少白内障摘除术中与瞳孔缩小相关的手术困难或并发症。[《屈光手术杂志》。2017；33(4)：230 - 234。]
