飞秒激光辅助白内障手术前滴眼液对房水中细胞因子浓度的影响。
Effect of preoperative eyedrops on cytokine concentrations in aqueous humor of patients undergoing femtosecond laser-assisted cataract surgery.
机构信息
Department of Ophthalmology, HanGil Eye Hospital, Incheon, Republic of Korea.
Department of Ophthalmology, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea.
出版信息
Graefes Arch Clin Exp Ophthalmol. 2022 Mar;260(3):885-891. doi: 10.1007/s00417-021-05428-1. Epub 2021 Oct 9.
PURPOSE
To compare the anti-inflammatory activity of preoperatively applied eyedrops, as determined by cytokine concentrations in aqueous humor collected during surgery in patients undergoing femtosecond laser-assisted cataract surgery.
METHODS
A total of 120 patients undergoing femtosecond laser-assisted cataract surgery were randomly assigned to four groups of 30 patients each. Groups were administered 0.1% fluorometholone eyedrops, 0.45% ketorolac tromethamine eyedrops, both 0.1% fluorometholone and 0.45% ketorolac tromethamine eyedrops, or no eyedrops. Eyedrops were instilled 1 h, 20 min, and just before surgery. After anterior capsulotomy and nuclear fragmentation using a femtosecond laser, 0.1 cc aqueous humor was obtained using a needle and syringe. Cytokine and prostaglandin E (PGE) concentrations were quantitatively determined.
RESULTS
The 120 patients included 59 men and 61 women, of mean age 65.02 years. The mean interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations after treatment did not differ significantly in the four groups. The average interleukin-8 (IL-8) concentrations were significantly lower in the fluorometholone (4.80 pg/mL), ketorolac tromethamine (4.84 pg/mL), and fluorometholone + ketorolac tromethamine (4.68 pg/mL) groups than in the control group (6.83 pg/mL). Furthermore, the average PGE concentrations were significantly lower in the ketorolac tromethamine (270.04 pg/mL) and fluorometholone + ketorolac tromethamine (239.00 pg/mL) groups, but not in the fluorometholone (393.16 pg/mL) group, than in the control group (472.36 pg/mL).
CONCLUSION
Preoperative fluorometholone instillation reduced IL-8, and ketorolac tromethamine instillation reduced IL-8 and PGE, in aqueous humor of patients undergoing femtosecond laser surgery, with the combination of both eyedrops being more effective than either alone.
TRIAL REGISTRATION
KCT0005717.
目的
通过比较在接受飞秒激光辅助白内障手术的患者手术中收集的房水细胞因子浓度，比较术前应用滴眼剂的抗炎活性。
方法
将 120 名接受飞秒激光辅助白内障手术的患者随机分为 4 组，每组 30 例。分别给予 0.1%氟米龙滴眼液、0.45%酮咯酸氨丁三醇滴眼液、0.1%氟米龙和 0.45%酮咯酸氨丁三醇滴眼液或无滴眼剂。滴眼剂于术前 1 h、20 min 和术前即刻给予。在前囊切开和飞秒激光核碎裂后，用针和注射器抽取 0.1 cc 房水。定量测定细胞因子和前列腺素 E（PGE）浓度。
结果
120 例患者包括 59 例男性和 61 例女性，平均年龄 65.02 岁。四组治疗后白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）浓度无显著差异。氟米龙（4.80 pg/mL）、酮咯酸氨丁三醇（4.84 pg/mL）和氟米龙+酮咯酸氨丁三醇（4.68 pg/mL）组的平均白细胞介素-8（IL-8）浓度明显低于对照组（6.83 pg/mL）。此外，酮咯酸氨丁三醇（270.04 pg/mL）和氟米龙+酮咯酸氨丁三醇（239.00 pg/mL）组的平均 PGE 浓度明显低于对照组（472.36 pg/mL），但氟米龙（393.16 pg/mL）组无差异。
结论
术前应用氟米龙滴眼可降低房水中的 IL-8，应用酮咯酸氨丁三醇滴眼可降低房水中的 IL-8 和 PGE，两种滴眼剂联合应用比单独应用更有效。
试验注册
KCT0005717。
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