局部应用阿可乐定对白内障囊外摘除联合小梁切除术后眼压升高频率的影响。

Effect of topical apraclonidine on the frequency of intraocular pressure elevations after combined extracapsular cataract extraction and trabeculectomy.

作者信息

Robin A L

机构信息

School of Hygiene and Public Health, Johns Hopkins University, Baltimore, MD.

出版信息

Ophthalmology. 1993 May;100(5):628-33. doi: 10.1016/s0161-6420(93)31603-9.

DOI:10.1016/s0161-6420(93)31603-9

PMID:8098520

Abstract

PURPOSE

A trabeculectomy is frequently combined with extracapsular cataract surgery to minimize the risks of further optic nerve damage associated with intraocular pressure (IOP) elevations after cataract surgery in eyes with glaucoma. Acute IOP elevations still occur after this combined surgery. The author evaluated the efficacy of 1% topical apraclonidine, a relatively selective alpha 2 agonist, in minimizing this complication.

METHODS

A prospective, randomized, double-masked study compared topical 1% apraclonidine with placebo. All eyes underwent otherwise uncomplicated combined trabeculectomy and extracapsular cataract surgery. They received the appropriate study drug before, immediately after, and 12 hours after surgery. Intraocular pressures were measured 24 hours and 1, 2, and 4 weeks after surgery.

RESULTS

One hundred nine eyes (of 109 patients) underwent combined surgery. Fifty-nine received placebo. Preoperative mean IOPs were 22.5 +/- 4.2 mmHg for eyes treated with placebo and 24.0 +/- 7.7 mmHg for eyes treated with apraclonidine. Twenty-four hours after surgery, mean IOPs were 23.1 +/- 17.4 mmHg for placebo-treated eyes and 11.6 +/- 11.3 mmHg for apraclonidine-treated eyes (P < 0.001). Twenty-four hours after surgery, 12 (20%) placebo-treated eyes and 1 (2%) apraclonidine-treated eye had IOPs greater than 40 mmHg (P < 0.005).

CONCLUSION

Apraclonidine effectively decreased large IOP elevations in glaucomatous eyes undergoing trabeculectomy combined with extracapsular cataract surgery.

摘要

目的

小梁切除术常与白内障囊外摘除术联合进行，以降低青光眼患者白内障手术后因眼压升高导致视神经进一步损伤的风险。但这种联合手术后仍会出现急性眼压升高的情况。作者评估了1%局部用阿可乐定（一种相对选择性的α2激动剂）在减少该并发症方面的疗效。

方法

一项前瞻性、随机、双盲研究将局部用1%阿可乐定与安慰剂进行了比较。所有眼睛均接受了无其他并发症的小梁切除术联合白内障囊外摘除术。患者在手术前、手术后立即以及手术后12小时接受相应的研究药物。在手术后24小时以及1、2和4周测量眼压。

结果

109例患者的109只眼睛接受了联合手术。59只眼睛接受了安慰剂治疗。接受安慰剂治疗的眼睛术前平均眼压为22.5±4.2 mmHg，接受阿可乐定治疗的眼睛术前平均眼压为24.0±7.7 mmHg。手术后24小时，接受安慰剂治疗的眼睛平均眼压为23.1±17.4 mmHg，接受阿可乐定治疗的眼睛平均眼压为11.6±11.3 mmHg（P<0.001）。手术后24小时，12只（20%）接受安慰剂治疗的眼睛和1只（2%）接受阿可乐定治疗的眼睛眼压高于40 mmHg（P<0.005）。