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眼内滴注卡巴胆碱和肾上腺素对单纯超声乳化术后脉络膜厚度的影响。

Effect of Intracameral Carbachol and Epinephrine Use on Choroidal Thickness After Uncomplicated Phacoemulsification.

机构信息

Department of Ophthalmology, Training and Research Hospital, Ordu University, Ordu, Turkey.

Department of Ophthalmology, Giresun University, Giresun, Turkey.

出版信息

Med Sci Monit. 2022 May 2;28:e935315. doi: 10.12659/MSM.935315.

DOI:10.12659/MSM.935315
PMID:35491490
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9074745/
Abstract

BACKGROUND Safety concerns about drugs used intracamerally during cataract surgery have been the subject of many studies. In this study, the effect of using intracameral carbachol and epinephrine on choroidal thickness was evaluated. MATERIAL AND METHODS This prospective interventional study included 81 eyes of 81 patients undergoing cataract surgery. During cataract surgery, intracameral carbachol was administered to 27 eyes, intracameral epinephrine was administered to 20 eyes, and 34 eyes were the control group. Macular choroidal thickness measurement was performed before, 1 day, and 1 week after phacoemulsification surgery in all patients using optical coherence tomography. RESULTS Subfoveal choroidal thickness was significantly reduced at day 1 and week 1 in the group receiving intraoperative carbachol compared with preoperative measurement (P=0.016). In addition, choroidal thickness in the 500 µm nasal fovea was significantly reduced in the carbachol group at 1st week compared to the preoperative measurement (P=0.008). There was no significant difference in postoperative subfoveal thickness in the intraoperative epinephrine group and control group (P=0.179 and P=0.953, respectively). Choroidal thickness at 1000 µm nasal fovea was significantly higher in the epinephrine group at postoperative 1st day than preoperative and postoperative 1st week values (P=0.009). CONCLUSIONS The use of intracameral epinephrine caused an increase in choroidal thickness 1000 µm nasal of the fovea, while intracameral carbachol caused thinning in the subfoveal and 500 µm nasal quadrant. Intracameral drug administration during cataract surgery may be associated with posterior segment complications.

摘要

背景

在白内障手术中使用的眼内药物的安全性问题一直是许多研究的主题。在这项研究中,评估了使用眼内卡巴胆碱和肾上腺素对脉络膜厚度的影响。

材料和方法

这项前瞻性干预研究包括 81 例 81 只眼接受白内障手术的患者。在白内障手术中,27 只眼给予眼内卡巴胆碱,20 只眼给予眼内肾上腺素,34 只眼为对照组。所有患者均采用光学相干断层扫描(OCT)在白内障超声乳化术前、术后 1 天和 1 周测量黄斑脉络膜厚度。

结果

与术前测量值相比,术中给予卡巴胆碱组术后第 1 天和第 1 周的中心凹下脉络膜厚度明显降低(P=0.016)。此外,与术前测量值相比,卡巴胆碱组术后第 1 周鼻侧黄斑 500 µm 处的脉络膜厚度明显降低(P=0.008)。术中给予肾上腺素组和对照组术后中心凹下厚度无显著差异(P=0.179 和 P=0.953)。术后第 1 天,肾上腺素组鼻侧黄斑 1000 µm 处的脉络膜厚度明显高于术前和术后第 1 周(P=0.009)。

结论

眼内给予肾上腺素可导致鼻侧黄斑 1000 µm 处脉络膜厚度增加,而眼内给予卡巴胆碱可导致中心凹下和鼻侧黄斑 500 µm 象限变薄。白内障手术中眼内药物的使用可能与后节并发症有关。

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本文引用的文献

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Eur Rev Med Pharmacol Sci. 2021 Jan;25(14):4773-4778. doi: 10.26355/eurrev_202101_26389.
2
Muscarinic Acetylcholine Receptors in the Retina-Therapeutic Implications.视网膜中的毒蕈碱型乙酰胆碱受体——治疗学意义。
Int J Mol Sci. 2021 May 8;22(9):4989. doi: 10.3390/ijms22094989.
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Choroidal and Retinal Changes After Systemic Adrenaline and Photodynamic Therapy in Non-Human Primates.非人类灵长类动物全身肾上腺素和光动力疗法后的脉络膜和视网膜变化。
Invest Ophthalmol Vis Sci. 2021 Mar 1;62(3):25. doi: 10.1167/iovs.62.3.25.
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Effect of intracameral epinephrine on heart rate, post-operative ocular hypertension, and long-term outcome following canine phacoemulsification.眼内肾上腺素对犬白内障超声乳化术后心率、眼内压升高及长期预后的影响。
Vet Ophthalmol. 2020 Sep;23(5):872-878. doi: 10.1111/vop.12812. Epub 2020 Aug 19.
5
Comparison of the effects of 1/10,000 and 1/100,000 concentrations of intracameral epinephrine on corneal endothelium and macular thickness after uncomplicated phacoemulsification.比较单纯超声乳化术后 1/10000 和 1/100000 浓度的房水内肾上腺素对角膜内皮和黄斑厚度的影响。
Eye (Lond). 2020 Dec;34(12):2300-2306. doi: 10.1038/s41433-020-0812-5. Epub 2020 Mar 3.
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Changes of Subfoveal Choroidal Thickness after Cataract Surgery: A Meta-Analysis.白内障手术后黄斑中心凹下脉络膜厚度的变化:一项荟萃分析。
J Ophthalmol. 2018 Nov 12;2018:2501325. doi: 10.1155/2018/2501325. eCollection 2018.
7
Changes in subfoveal choroidal thickness after uncomplicated cataract surgery.单纯性白内障手术后黄斑中心凹下脉络膜厚度的变化
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2019 Jun;163(2):179-183. doi: 10.5507/bp.2018.076. Epub 2018 Dec 18.
8
Effects of intracameral injection of epinephrine and 2% lidocaine on pupil diameter, intraocular pressure, and cardiovascular parameters in healthy cats.前房内注射肾上腺素和2%利多卡因对健康猫瞳孔直径、眼压和心血管参数的影响。
Vet Ophthalmol. 2019 May;22(3):276-283. doi: 10.1111/vop.12588. Epub 2018 Jul 5.
9
Changes in Choroidal Thickness after Cataract Surgery.白内障手术后脉络膜厚度的变化
Semin Ophthalmol. 2018;33(5):664-670. doi: 10.1080/08820538.2017.1416410. Epub 2017 Dec 26.
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Clin Ophthalmol. 2016 May 26;10:961-7. doi: 10.2147/OPTH.S94096. eCollection 2016.