Department of Ophthalmology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Tianjin, 300052, China.
Department of Fundus Diseases, Shanxi Eye Hospital, Taiyuan, 030002, Shanxi, China.
BMC Ophthalmol. 2021 Jun 4;21(1):245. doi: 10.1186/s12886-021-02017-y.
We aimed to evaluate the efficacy and safety of phacoemulsification with intravitreal 3 mg triamcinolone acetonide injection in preventing postoperative inflammation and complications in patients with non-infectious anterior uveitis and panuveitis complicated cataract.
In this retrospective cohort study, 140 uveitic cataract patients who received phacoemulsification and intraocular lens implantation in Shanxi Eye hospital from January 2018 to January 2020 were reviewed. The IVTA group (51 eyes of 41 patients) received intravitreal injection of 3 mg triamcinolone acetonide (TA) at the end of surgery, and the control group (51 eyes of 41 patients) without injection matched by propensity score matching were enrolled. Outcome measures were best corrected visual acuity (BCVA), anterior chamber inflammation, intraocular pressure, corneal endothelial cell density, central macular thickness and complications within 3 months follow-up.
The degree of postoperative anterior chamber inflammation in the IVTA group was lighter than that in the control group (P < 0.05). The postoperative logMAR BCVA of anterior uveitis was better and improved more quickly in the IVTA group(P < 0.05). Postoperative time of using corticosteroids was shorter in the IVTA group as compared to the control group (P < 0.05). The central macular thickness at postoperative month 1 was statistically significantly lower in the IVTA group (P < 0.05). There were no statistically significant differences between the two groups in postoperative corneal endothelial cell density and intraocular pressure (P > 0.05). Two of 51 eyes (3.9%) in the IVTA group and 8 of 51 eyes (15.7%) in the control group had recurrence of uveitis; 6 of 45 eyes (13.3%) in the control group developed cystoid macular edema but none in the IVTA group; 11 of 51 eyes (21.6%) in the IVTA group and 22 of 51 eyes (43.1%) in the control group developed posterior synechiae postoperatively.
Intraoperative Intravitreal injection of 3 mg TA is an effective and safe adjunctive therapy for preventing postoperative inflammation and complications to promote early recovery for anterior uveitis or panuveitis complicated cataract patients following phacoemulsification.
This retrospective cohort study was in accordance with the tenets of the Helsinki Declaration and was approved by the Shanxi Eye Hospital Ethics Committee. Written informed consent was obtained from all participants for their clinical records to be used in this study.
我们旨在评估白内障超声乳化术中玻璃体内注射 3mg 曲安奈德在预防非感染性前葡萄膜炎和全葡萄膜炎合并白内障患者术后炎症和并发症方面的疗效和安全性。
在这项回顾性队列研究中，我们对 2018 年 1 月至 2020 年 1 月在山西眼科医院接受白内障超声乳化术和人工晶状体植入术的 140 例葡萄膜炎性白内障患者进行了回顾性分析。在手术结束时，IVTA 组（41 例患者的 51 只眼）接受玻璃体内注射 3mg 曲安奈德（TA），对照组（41 例患者的 51 只眼）为经倾向评分匹配的未注射患者。观察指标为最佳矫正视力（BCVA）、前房炎症、眼压、角膜内皮细胞密度、黄斑中心厚度和术后 3 个月内的并发症。
IVTA 组术后前房炎症程度轻于对照组（P<0.05）。IVTA 组葡萄膜炎术后 logMAR BCVA 更好，改善更快（P<0.05）。IVTA 组术后使用皮质类固醇的时间短于对照组（P<0.05）。IVTA 组术后 1 个月中央黄斑厚度明显低于对照组（P<0.05）。两组术后角膜内皮细胞密度和眼压差异无统计学意义（P>0.05）。IVTA 组 51 只眼中有 2 只（3.9%）和对照组 51 只眼中有 8 只（15.7%）发生葡萄膜炎复发；对照组 45 只眼中有 6 只（13.3%）发生囊样黄斑水肿，而 IVTA 组中没有；IVTA 组 51 只眼中有 11 只（21.6%）和对照组 51 只眼中有 22 只（43.1%）发生术后后粘连。
白内障超声乳化术中玻璃体内注射 3mg TA 是一种有效且安全的辅助治疗方法，可预防术后炎症和并发症，促进前葡萄膜炎或全葡萄膜炎合并白内障患者术后早期恢复。
本回顾性队列研究符合赫尔辛基宣言的原则，并获得山西眼科医院伦理委员会的批准。所有参与者均签署书面知情同意书，同意将其临床记录用于本研究。
