Department of Ophthalmology, Mie University School of Medicine, Tsu, Japan.
Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan.
Cornea. 2019 Nov;38 Suppl 1:S25-S33. doi: 10.1097/ICO.0000000000002125.
Surgical intervention is the most effective treatment for decreased vision resulting from cataracts. Although the current procedures for cataract surgery are safe and effective, it is well known that several complications can develop after surgery. Postoperative cystoid macular edema (CME) is a well-known complication, and prophylactic medications such as steroids and/or nonsteroidal antiinflammatory drugs are routinely used for its prevention. Ocular surface abnormalities, such as dry eye, have also been reported to develop after cataract surgery. However, the causative mechanisms for postoperative dry eye have not been definitively determined. At present, there are no prophylactic medications that are commonly used to prevent the development of postoperative dry eye. Although nonsteroidal antiinflammatory drugs are very effective in reducing the incidence and degree of postoperative CME, it is known that they can cause adverse side effects, including ocular surface abnormalities. Thus, perioperative medications must be carefully selected to improve surgical outcomes and patient satisfaction. Here, we summarize the results of recent studies on postoperative dry eye and CME that can develop after cataract surgery. We suggest appropriate combinations of medications that can be used to minimize these postsurgical complications.
手术干预是治疗白内障导致视力下降最有效的方法。虽然目前白内障手术的程序是安全有效的，但众所周知，手术后会出现几种并发症。术后囊样黄斑水肿（CME）是一种众所周知的并发症，为预防其发生，常规使用类固醇和/或非甾体抗炎药等预防药物。白内障手术后还会出现眼部表面异常，如干眼症。然而，术后干眼症的发病机制尚未明确。目前，没有常用的预防药物可用于预防术后干眼症的发生。虽然非甾体抗炎药在降低术后 CME 的发生率和严重程度方面非常有效，但众所周知，它们会引起不良反应，包括眼部表面异常。因此，围手术期药物的选择必须慎重，以提高手术效果和患者满意度。在这里，我们总结了白内障手术后可能发生的术后干眼症和 CME 的最新研究结果。我们建议使用适当的药物组合，以最小化这些手术后的并发症。
