Kohnen T, Dick B, Hessemer V, Jacobi K W
Universitäts-Augenklinik Geissen.
Ophthalmologe. 1995 Jun;92(3):297-302.
The use of heparin prevented postoperative intraocular fibrin-clot formation in the rabbit after vitrectomy and cyclocryotherapy. A low rate of postoperative intraocular inflammation was observed in our patients receiving phacoemulsification with heparin infusion solution (slit-lamp examination). To verify this effect a randomized, prospective study was performed using laser-flare cell photometry (LFCP) for measuring protein concentration in the anterior chamber.
Seventy-two patients (49-87 years of age) were randomly assigned to one of the following two surgical groups (temporal clear corneal tunnel incision with phacoemulsification): group A: foldable silicone IOL (Chiron C10), no stitch (3.5 mm incision); group B: PMMA-IOL (Pharmacia 809P) with one radial suture (5 mm incision). Fifty percent of the patients in each group received, in addition to the regular phaco infusion, 1 ml of heparin sodium (-H = without heparin; +H = with heparin). Aqueous flare was measured preoperatively as well as on days 1 and 3 following phaco + IOL with LFCP (Modell FC-1000; Kowa Company).
In group A1 (-H) or B1 (-H) the mean flare values (in photon counts/ms) increased from a preoperative value of 7.0 +/- 1.7 (mean +/- SD) or 6.9 +/- 1.2 to 20.2 +/- 3.1 or 20.1 +/- 3.0 on the 1st postoperative day, whereas they decreased again to 13.8 +/- 2.9 or 14.8 +/- 3.1 on day 3 following surgery. In groups with heparin sodium A2(+H) and B2(+H) the flare values only increased from 7.2 +/- 1.3 or 7.1 +/- 1.3 to 12.9 +/- 4.0 or 13.8 +/- 3.8 on day 1, and decreased to 8.0 +/- 2.8 or 8.8 +/- 3.0 on the 3rd postoperative day. The mean postoperative flare values were significantly lower in the groups with additional heparin (p < 0.01).
Heparin sodium in the infusion solution during small incision cataract surgery showed an antiinflammatory effect in the early postoperative period. There was no significant difference between the two IOL materials.
在兔玻璃体切割术和睫状体冷凝术后，肝素的使用可预防术后眼内纤维蛋白凝块形成。在接受肝素输注溶液超声乳化术的患者中（裂隙灯检查），观察到术后眼内炎症发生率较低。为验证这种效果，进行了一项随机前瞻性研究，使用激光散射细胞光度法（LFCP）测量前房内蛋白质浓度。
72例患者（年龄49 - 87岁）被随机分配到以下两个手术组之一（颞侧透明角膜隧道切口超声乳化术）：A组：可折叠硅胶人工晶状体（Chiron C10），无缝线（3.5mm切口）；B组：PMMA人工晶状体（Pharmacia 809P），有一条放射状缝线（5mm切口）。每组50%的患者除常规超声乳化灌注外，还接受1ml肝素钠（-H = 无肝素；+H = 有肝素）。术前以及超声乳化 + 人工晶状体植入术后第1天和第3天，用LFCP（Modell FC - 1000；Kowa公司）测量房水闪光值。
在A1（-H）组或B1（-H）组中，平均闪光值（光子计数/毫秒）从术前的7.0±1.7或6.9±1.2增加到术后第1天的20.2±3.1或20.1±3.0，而在术后第3天又降至13.8±2.9或14.8±3.1。在使用肝素钠的A2（+H）组和B2（+H）组中，闪光值仅在第1天从7.2±1.3或7.1±1.3增加到12.9±4.0或13.8±3.8，并在术后第3天降至8.0±2.8或8.8±3.0。额外使用肝素的组术后平均闪光值显著较低（p < 0.01）。
小切口白内障手术期间输注溶液中的肝素钠在术后早期显示出抗炎作用。两种人工晶状体材料之间无显著差异。
