Dietlein Thomas S, Erb Carl, Hoffmann Esther
Augenklinik, Universitätskliniken Köln.
Nussbaumallee 17, 14059 Berlin.
Klin Monbl Augenheilkd. 2019 May;236(5):647-652. doi: 10.1055/a-0852-4967. Epub 2019 May 16.
Many clinical studies have demonstrated the benefit of topical anti-inflammatory medication before and after glaucoma surgery, especially for trabeculectomy, and that they improve the long term outcome. Pre- and postoperative topical steroids improve the outcome of trabeculectomy, but duration and intensity of treatment should be adapted individually. Systemic steroid or oral immunomodulation have significant impact on the outcome in uveitic glaucoma, but not in other glaucoma subtypes. Additional topical treatment with non-steroidal anti-inflammatories is an option in combined cataract-glaucoma surgery. Anti-inflammatory treatment after selective laser trabeculoplasty is not necessary, but relieves pain after argon laser trabeculoplasty and laser cyclophotocoagulation. Intravitreal application of steroids in glaucoma surgery must be critically evaluated and must consider the risk of a rise in secondary intraocular pressure.
许多临床研究已证明青光眼手术前后局部使用抗炎药物的益处，尤其是小梁切除术，且这些药物可改善长期预后。术前和术后局部使用类固醇可改善小梁切除术的预后，但治疗的持续时间和强度应因人而异。全身使用类固醇或口服免疫调节药物对葡萄膜炎性青光眼的预后有显著影响，但对其他青光眼亚型则无影响。在白内障合并青光眼手术中，额外局部使用非甾体类抗炎药是一种选择。选择性激光小梁成形术后无需进行抗炎治疗，但氩激光小梁成形术和激光睫状体光凝术后可缓解疼痛。青光眼手术中玻璃体内注射类固醇必须进行严格评估，且必须考虑继发性眼压升高的风险。
