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地塞米松玻璃体内植入物治疗白内障合并初发糖尿病性黄斑水肿患者。

Dexamethasone intravitreal implant in patients with cataract and naïve diabetic macular edema.

机构信息

Department of Ophthalmology, University of Foggia, Foggia, Italy.

出版信息

Eur J Ophthalmol. 2022 Jan;32(1):364-371. doi: 10.1177/11206721211004395. Epub 2021 Mar 23.

Abstract

PURPOSE

To assess the feasibility and clinical effectiveness of dexamethasone intravitreal implant 0.7 mg (IDI) administered in diabetic patients to prevent the worsening of macular edema.

METHODS

Forty eyes of 40 consecutive patients with naïve macular edema secondary to diabetes mellitus who were treated with IDI administered preoperative (Group A: 20 patients) or IDI administered immediately after cataract surgery (Group B: 20 patients). Best-corrected visual acuity (BCVA) and central macular thickness (CMT) changes were evaluated at baseline and at postoperative time points.

RESULTS

Follow-up study was 20 weeks. In Group A and B, mean BCVA improved significantly at all post-surgery time points ( < 0.05). In Group A and B, mean CMT decreased significantly at 16 weeks ( = 0.02 and  = 0.004, respectively). At week 20, CMT failed to reach statistical significance in both groups ( = 0.5, group A and  = 0.15, group B). No statistical differences were noted between groups in term of BCVA (with the exception of week 4 for the presence of cataract in Group A), CMT and IOP.

CONCLUSIONS

The use of intravitreal dexamethasone implant 1 month prior to scheduled cataract extraction or at the time of phacoemulsification appears to be safe and effective for at least 16 weeks after surgery.

摘要

目的

评估玻璃体内注射地塞米松 0.7mg 植入物(IDI)在预防糖尿病患者黄斑水肿恶化中的可行性和临床疗效。

方法

连续 40 例糖尿病性黄斑水肿初治患者的 40 只眼接受了 IDI 治疗,术前(A 组:20 例)或白内障手术后即刻(B 组:20 例)给予 IDI。在基线和术后时间点评估最佳矫正视力(BCVA)和中央黄斑厚度(CMT)变化。

结果

随访研究为 20 周。在 A 组和 B 组中,所有术后时间点的平均 BCVA 均显著改善( < 0.05)。在 A 组和 B 组中,平均 CMT 在 16 周时显著降低( = 0.02 和  = 0.004)。在第 20 周,两组的 CMT 均未达到统计学意义( = 0.5,A 组和  = 0.15,B 组)。在 BCVA(除 A 组白内障存在时第 4 周外)、CMT 和 IOP 方面,两组之间无统计学差异。

结论

在计划进行白内障摘除术前 1 个月或在白内障超声乳化术时使用玻璃体内地塞米松植入物似乎是安全有效的,至少在术后 16 周内有效。

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