Loukovaara Sirpa, Haukka JJari
Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Hospital, and Individualized Drug Therapy Research Program, University of Helsinki, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
J Ophthalmic Vis Res. 2022 Apr 29;17(2):186-195. doi: 10.18502/jovr.v17i2.10789. eCollection 2022 Apr-Jun.
To examine the association between the use of topical non-steroidal anti-inflammatory (NSAID) medication, systemic statin therapy, and the incidence rate of two of the most common postsurgical procedures in adult patients undergoing cataract surgery in Finland between January 1, 2010 and December 31, 2016.
This retrospective, nationwide cohort study considered 176,052 cataract operations coded with the International Classification of Disease coding: early adult (H25.0), normal (H25.1), other senile (H25.8), pre-senile (H26.02), or other (related to trauma, other eye disease, or medication). Operations were linked to purchased and reimbursed medications using Anatomical Therapeutic Chemical codes. The incidence rate of intravitreal anti-vascular endothelial growth factor (VEGF) injections, and neodymium-doped yttrium aluminum (Nd:YAG) laser treatments of posterior capsular opacification were evaluated using the Poisson regression model.
In our registry cohort, patients with a prescription of topical NSAID (ketorolac) at the time of cataract surgery were less likely treated with intravitreal anti-VEGF injections after surgery (adjusted Poisson regression model IRR 0.3; 95% CI: 0.15-0.60, = 0.0007), and also had reduced incidence of Nd:YAG laser (0.59, CI: 0.43-0.81, = 0.0011) treatments. Unlike topical NSAID, the use of systemic statin therapy was not associated with these two most common surgical procedures (RR 1.04, 95% CI: 0.96-1.12, = 0.33).
The use of topical NSAIDs is associated with reduced rates of intravitreal anti-VEGF injections and Nd:YAG laser treatments after cataract surgery. More observational and experimental studies are warranted to confirm possible benefits of topical NSAID administration after cataract surgery.
研究局部使用非甾体抗炎药（NSAID）、全身使用他汀类药物治疗与2010年1月1日至2016年12月31日期间在芬兰接受白内障手术的成年患者中两种最常见手术后操作发生率之间的关联。
这项回顾性全国队列研究纳入了176,052例白内障手术，这些手术采用国际疾病分类编码：早发性成人（H25.0）、正常（H25.1）、其他老年性（H25.8）、早老性（H26.02）或其他（与创伤、其他眼病或药物相关）。手术通过解剖治疗化学编码与购买和报销的药物相关联。使用泊松回归模型评估玻璃体内抗血管内皮生长因子（VEGF）注射以及钕掺杂钇铝石榴石（Nd:YAG）激光治疗后囊膜混浊的发生率。
在我们的登记队列中，白内障手术时开具局部NSAID（酮咯酸）处方的患者术后接受玻璃体内抗VEGF注射治疗的可能性较小（调整后的泊松回归模型IRR为0.3；95%CI：0.15 - 0.60，P = 0.0007），Nd:YAG激光治疗的发生率也较低（0.59，CI：0.43 - 0.81，P = 0.0011）。与局部NSAID不同，全身使用他汀类药物治疗与这两种最常见的手术操作无关（RR为1.04，95%CI：0.96 - 1.12，P = 立33）。
局部使用NSAIDs与白内障手术后玻璃体内抗VEGF注射率和Nd:YAG激光治疗率降低有关。需要更多的观察性和实验性研究来证实白内障手术后局部使用NSAID的潜在益处。
