From the Department of Ophthalmology, Rigshospitalet-Glostrup (Erichsen, Holm, Kessel), Glostrup, Section of Biostatistics, Department of Public Health (Forman), Department of Clinical Medicine (Holm, Kessel), University of Copenhagen, Copenhagen, Denmark.
J Cataract Refract Surg. 2021 Mar 1;47(3):323-330. doi: 10.1097/j.jcrs.0000000000000455.
To investigate whether a combination of topical nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids were superior in controlling early postoperative inflammation after cataract surgery compared with topical NSAIDs alone and with dropless surgery where a sub-Tenon depot of steroid was placed during surgery.
Department of Ophthalmology, Rigshospitalet-Glostrup, Denmark.
Prospective randomized controlled trial with masked statistical analyses.
Patients undergoing phacoemulsification for age-related cataract were randomized to 1 of 5 regimens: ketorolac and prednisolone eyedrops combined (Pred+NSAID-Pre [control group] and Pred+NSAID-Post group) vs ketorolac monotherapy (NSAID-Pre and NSAID-Post groups) vs sub-Tenon depot of dexamethasone (dropless group). Drops were used until 3 weeks postoperatively, starting 3 days preoperatively in the Pre groups and on the day of surgery in the Post groups. Aqueous flare was measured at baseline and 3 days postoperatively.
Four hundred fifty-six participants, with a mean age of 72.1 (SD 7.0) years and 283 (62%) women, were included. Flare increased significantly more in the dropless group compared with the control group (Pred+NSAID-Pre), but none of the other groups differed significantly from the control group. Intraocular pressure decreased in all groups but significantly less in groups receiving prednisolone eyedrops (Pred+NSAID-Pre and Pred+NSAID-Post groups) compared with NSAID monotherapy and dropless groups. No differences in postoperative visual acuity were found compared with the control group.
No differences were found between groups randomized to NSAID monotherapy or combination of NSAID and steroid in controlling early inflammation after cataract surgery, but sub-Tenon depot of dexamethasone was less efficient. Initiating prophylactic eyedrops prior to surgery did not influence early postoperative anterior chamber inflammation.
研究与单独使用局部非甾体类抗炎药（NSAIDs）以及术中在眼颞下放置类固醇混悬液的无滴剂手术相比，局部 NSAIDs 联合类固醇是否能更有效地控制白内障术后早期炎症。
丹麦里格斯霍尔姆医院眼科。
前瞻性随机对照试验，采用盲法统计学分析。
对因年龄相关性白内障而行超声乳化术的患者进行随机分组，接受以下 5 种方案之一的治疗：酮咯酸和泼尼松龙滴眼剂联合（Pred+NSAID-Pre[对照组]和 Pred+NSAID-Post 组）、酮咯酸单药治疗（NSAID-Pre 和 NSAID-Post 组）、眼颞下注射地塞米松混悬液（无滴剂组）。术前 3 天开始滴用滴眼剂（Pre 组），术后开始滴用滴眼剂（Post 组），直至术后 3 周。于基线和术后 3 天测量房水闪辉。
共纳入 456 例患者，平均年龄 72.1（SD 7.0）岁，283 例（62%）为女性。与对照组（Pred+NSAID-Pre）相比，无滴剂组的房水闪辉显著增加，但其余组与对照组相比差异无统计学意义。所有组的眼内压均降低，但接受泼尼松龙滴眼剂治疗的组（Pred+NSAID-Pre 和 Pred+NSAID-Post 组）与 NSAID 单药治疗组和无滴剂组相比，眼内压降低更显著。与对照组相比，各组的术后视力均无显著差异。
与 NSAID 单药治疗或 NSAID 联合类固醇治疗相比，随机分组至 NSAID 单药治疗或 NSAID 联合类固醇治疗的各组在控制白内障术后早期炎症方面无差异，但眼颞下注射地塞米松混悬液的效果较差。术前开始预防性滴眼剂治疗并未影响术后早期前房炎症。
