Ruiz R S, Rhem M N, Prager T C
Department of Ophthalmology, University of Texas Health Science Center, Houston 77030.
Am J Ophthalmol. 1989 Jan 15;107(1):7-10. doi: 10.1016/0002-9394(89)90806-4.
We compared the effect of carbachol and acetylcholine on intraocular pressure 24 hours after extracapsular cataract extraction. All agents were administered intracamerally at the time of surgery. Sixty patients scheduled for routine extracapsular cataract extraction and intraocular lens implantation were randomly assigned into one of three treatment groups: (1) carbachol, (2) acetylcholine, or (3) 0.5% balanced salt solution (placebo). Baseline intraocular pressures were determined the day before surgery, and postoperative pressures were measured approximately 24 hours after surgery. The group intraocular pressures averaged over preoperative and postoperative values were 21.06 mm Hg in the acetylcholine group, 19.36 mm Hg in the control group, and 17.30 mm Hg in the carbachol group. The average difference between preoperative and postoperative intraocular pressure measurements for the three groups were 7.33 mm Hg for the acetylcholine group, 8.73 mm Hg for the control group, and 2.20 mm Hg for the carbachol group. Only carbachol was significantly different from placebo on statistical subsequent testing. Carbachol is suggested as the agent of choice both for achieving intrasurgical miosis and prophylaxis of increasing intraocular pressure after cataract surgery.
我们比较了卡巴胆碱和乙酰胆碱对白内障囊外摘除术后24小时眼压的影响。所有药物均在手术时前房内给药。将60例计划进行常规白内障囊外摘除术和人工晶状体植入术的患者随机分为三个治疗组之一：（1）卡巴胆碱组，（2）乙酰胆碱组，或（3）0.5%平衡盐溶液（安慰剂组）。术前一天测定基线眼压，术后约24小时测量眼压。乙酰胆碱组术前和术后眼压的平均值为21.06 mmHg，对照组为19.36 mmHg，卡巴胆碱组为17.30 mmHg。三组术前和术后眼压测量值的平均差值分别为：乙酰胆碱组7.33 mmHg，对照组8.73 mmHg，卡巴胆碱组2.20 mmHg。在后续统计学检验中，只有卡巴胆碱组与安慰剂组有显著差异。建议将卡巴胆碱作为白内障手术中实现瞳孔缩小和预防眼压升高的首选药物。
