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眼内注射米坦那可作为白内障手术中散瞳滴剂滴眼的替代方法。

Mydrane intracameral injection site can be an alternative to mydriatic drops instillation in cataract surgery.

机构信息

Jagiellonian University Medical College, Faculty of Medicine, Division of Ophthalmology, Cracow, Poland.

出版信息

J Physiol Pharmacol. 2020 Apr;71(2). doi: 10.26402/jpp.2020.2.08. Epub 2020 Jul 2.

Abstract

The aim of this study is to compare Mydrane (combination of tropicamide 0.02%, phenylephrine 0.31% and lidocaine 1%) and mydriatic drops (tropicamide 1% and phenylephrine 10%) used for cataract surgery in terms of efficacy in pupil dilation and impact on corneal endothelial cell density (CD) and central corneal thickness (CCT). Prospective study including 64 eyes of 64 patients that underwent phacoemulsification with intraocular lens implantation. Patients were randomized into two groups: Mydrane group received: tropicamide and phenylephrine one day preoperatively and Mydrane during the surgery. Reference group received: tropicamide and phenylephrine preoperatively. Pupil size was measured only in Mydrane group, in the same eye of the same patient one day preoperatively after mydriatic drops were given and during the surgery, after intracameral Mydrane injection. CD and CCT were evaluated one day preoperatively and one month postoperatively in all patients and compared between Mydrane and reference groups. The results show CCT and CD significantly decreased after surgery in both groups. There is no difference in this decrease between groups. In Mydrane group there was no difference in dilated pupil diameter between Mydrane and mydriatic drops. Gender, diabetes mellitus, POAG, alpha-1 blocker treatment failed to affect pupil dilation obtained with Mydrane. Cataract surgery affects CCT and CD regardless of which mydriatic protocol had been used. Pupil diameter was similar after drops instillation and after Mydrane injection in all patients from the Mydrane group.

摘要

本研究旨在比较美多丽(托吡卡胺 0.02%、苯肾上腺素 0.31%和利多卡因 1%的组合)和美多丽滴眼剂(托吡卡胺 1%和苯肾上腺素 10%)在白内障手术中散瞳效果方面的差异,并评估其对角膜内皮细胞密度(CD)和中央角膜厚度(CCT)的影响。这是一项前瞻性研究,纳入了 64 例接受白内障超声乳化联合人工晶状体植入术的患者,共 64 只眼。患者随机分为两组:美多丽组于术前 1 天及手术中使用托吡卡胺和苯肾上腺素,参考组于术前使用托吡卡胺和苯肾上腺素。仅在美多丽组测量瞳孔大小,在同一只眼的同一患者中,在术前滴用散瞳剂后 1 天及手术中眼内注射美多丽后进行测量。所有患者均于术前 1 天及术后 1 个月评估 CD 和 CCT,并比较美多丽组与参考组之间的差异。结果显示,两组术后 CCT 和 CD 均显著下降。两组间这种下降无差异。在美多丽组,美多丽与散瞳剂滴眼之间的瞳孔直径无差异。性别、糖尿病、POAG、α-1 阻滞剂治疗失败均未能影响美多丽散瞳效果。白内障手术会影响 CCT 和 CD,无论使用哪种散瞳方案。在美多丽组的所有患者中,滴眼后与眼内注射美多丽后,瞳孔直径均相似。

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