Apt L, Voo I, Isenberg S J
Jules Stein Eye Institute, UCLA 90095-7000, USA.
Ophthalmology. 1998 Aug;105(8):1448-52; discussion 1453-4. doi: 10.1016/S0161-6420(98)98026-5.
This study aimed to compare the anti-inflammatory and analgesic effects of topical diclofenac sodium 0.1% (Voltaren) with prednisolone sodium phosphate 1% ophthalmic solution after strabismus surgery.
A prospective, double-masked, randomized, two-center clinical trial.
Eighty eyes of 52 patients undergoing strabismus surgery were examined.
For 1 week after surgery, the eye that was operated on received one drop of either diclofenac or prednisolone four times a day.
The diclofenac- and prednisolone-treated eyes were compared on postoperative days 3 and 7 with respect to signs of inflammation (e.g., erythema, edema, discharge), patient comfort, and conjunctival incisional healing.
On postoperative day 7, in eyes that received prednisolone, the conjunctival defects were larger (P = 0.004) and more frequent (P = 0.02). For all subjects, despite adequate statistical power, there was no statistically significant difference in inflammatory scores between eyes that received diclofenac or prednisolone. In cases of bilateral surgery, however, there was less postoperative erythema and edema in the diclofenac-treated eyes.
In the first week after strabismus surgery, topical diclofenac proved at least as effective as prednisolone in controlling inflammation and discomfort with less delay in incisional wound healing. Topical diclofenac, a nonsteroidal anti-inflammatory agent, may be considered for use after strabismus surgery in place of corticosteroids.
本研究旨在比较0.1%双氯芬酸钠（扶他林）与1%磷酸泼尼松龙滴眼液在斜视手术后的抗炎和镇痛效果。
一项前瞻性、双盲、随机、双中心临床试验。
对52例接受斜视手术患者的80只眼睛进行检查。
术后1周内，手术眼每天滴注一滴双氯芬酸或泼尼松龙，共4次。
比较双氯芬酸和泼尼松龙治疗组在术后第3天和第7天的炎症体征（如红斑、水肿、分泌物）、患者舒适度和结膜切口愈合情况。
术后第7天，接受泼尼松龙治疗的眼睛结膜缺损更大（P = 0.004）且更频繁（P = 0.02）。对于所有受试者，尽管有足够的统计效力，但接受双氯芬酸或泼尼松龙治疗的眼睛之间炎症评分无统计学显著差异。然而，在双侧手术的情况下，双氯芬酸治疗的眼睛术后红斑和水肿较少。
在斜视手术后的第一周，局部应用双氯芬酸在控制炎症和不适方面至少与泼尼松龙一样有效，且切口愈合延迟较少。局部应用双氯芬酸这种非甾体抗炎药可考虑在斜视手术后替代皮质类固醇使用。
