a Akdeniz University , Department of Ophthalmology , Antalya , Turkey.
b Elmali State Hospital , Antalya , Turkey.
Ocul Immunol Inflamm. 2019;27(2):312-318. doi: 10.1080/09273948.2017.1410182. Epub 2017 Dec 28.
To compare the efficacy and safety of postoperative topical loteprednol etabonate (LE) 0.5% with dexamethasone (DEX) 0.1% for the treatment of inflammation following pars plana vitrectomy (PPV).
A total of 150 eyes of 150 patients who underwent transconjunctival PPV for various diagnoses were included in this prospective, randomized study. The patients were assigned into two groups as Group LE (n = 75) and Group DEX (n = 75). Intraocular inflammation, intraocular pressure (IOP), and the intensity of postoperative pain were compared between the groups.
The mean IOP was higher in the patients treated with DEX (p > 0.05). The need for anti-glaucoma medications was significantly lower in Group LE (5.3%) than in Group DEX (17.3%) (p = 0.020). Tyndall scores were less in Group DEX at postoperative Days 1 (p = 0.01) and 3 (p = 0.017). On Day 1, it was more likely for patients to have mild or moderate pain in Group LE (p < 0.001). On Day 3, the number of the patients with no pain was higher in Group DEX (p = 0.005).
Although DEX is more effective in the early postoperative days, LE appears to be as effective in controlling inflammatory response following PPV in the long-term. Topical LE is associated with less increase in the IOP and a lower need for anti-glaucoma medications.
比较术后局部应用曲安奈德（DEX）0.1%与洛度沙胺（LE）0.5%治疗玻璃体切除术（PPV）后炎症的疗效和安全性。
本前瞻性、随机研究纳入了 150 例因各种诊断接受经结膜 PPV 的患者的 150 只眼。患者被分为两组，即 LE 组（n=75）和 DEX 组（n=75）。比较两组患者的眼内炎症、眼内压（IOP）和术后疼痛强度。
DEX 治疗组的平均 IOP 较高（p>0.05）。LE 组（5.3%）需要抗青光眼药物治疗的患者明显少于 DEX 组（17.3%）（p=0.020）。DEX 组在术后第 1 天（p=0.01）和第 3 天（p=0.017）的 Tyndall 评分较低。在第 1 天，LE 组患者发生轻度或中度疼痛的可能性更大（p<0.001）。在第 3 天，DEX 组无疼痛的患者人数更多（p=0.005）。
尽管 DEX 在术后早期更有效，但 LE 在长期内似乎同样能有效控制 PPV 后的炎症反应。局部应用 LE 可使 IOP 升高减少，需要抗青光眼药物治疗的可能性降低。
