Taravella M, Stepp P, Young D
Department of Ophthalmology, University of Colorado School of Medicine, Denver, USA.
CLAO J. 1998 Jul;24(3):166-8.
The purpose of this study was to determine the ocular penetration of tobramycin into the anterior chamber of the human eye when delivered by a pre-soaked collagen shield.
We conducted a prospective, randomized study of 32 patients undergoing cataract surgery. The subjects were divided into two groups. The first group received three preoperative drops of commercially available combination tobramycin-dexamethasone drops at 15 minute intervals. In the second group, a collagen shield soaked in the same medication was applied to the eye prior to surgery. At the beginning of surgery, the aqueous humor was extracted for analysis.
The samples from 11 patients could not be analyzed due to an insufficient aqueous sample. Of the remaining 21 patients, the mean aqueous concentration was 0.026 microgram/mL (range: 0.0-0.09) in the drops group and 0.024 microgram/mL (range: 0.04-0.8 microgram/mL) in the shield group. This difference was not statistically significant. The aqueous concentration in both groups did not approach the minimum inhibitory concentration (4 micrograms/mL) for common ocular pathogens. No adverse effects related to the use of collagen shields occurred.
Perioperative use of a pre-soaked collagen shield utilizing a commercially available preparation of tobramycin-dexamethasone combination drops appears safe. However, the use of this system to prevent endophthalmitis is not warranted based on the concentrations obtained from the aqueous humor.
本研究的目的是确定当通过预先浸泡的胶原盾递送时，妥布霉素在人眼前房中的眼内渗透率。
我们对32例接受白内障手术的患者进行了一项前瞻性随机研究。受试者分为两组。第一组在术前每隔15分钟滴入三滴市售的妥布霉素 - 地塞米松联合滴眼液。在第二组中，在手术前将浸泡在相同药物中的胶原盾应用于眼睛。在手术开始时，抽取房水进行分析。
由于房水样本不足，11例患者的样本无法分析。在其余21例患者中，滴眼液组的平均房水浓度为0.026微克/毫升（范围：0.0 - 0.09），胶原盾组为0.024微克/毫升（范围：0.04 - 0.8微克/毫升）。这种差异无统计学意义。两组的房水浓度均未达到常见眼部病原体的最低抑菌浓度（4微克/毫升）。未发生与使用胶原盾相关的不良反应。
使用市售的妥布霉素 - 地塞米松联合滴眼液预先浸泡的胶原盾进行围手术期使用似乎是安全的。然而，基于从房水中获得的浓度，使用该系统预防眼内炎是不必要的。
