Shepherd W F, Fsadni M G, Raj P S
Department of Ophthalmology, Borders General Hospital, Melrose, UK.
Ocul Immunol Inflamm. 1998 Mar;6(1):13-8. doi: 10.1076/ocii.6.1.13.8083.
The purpose of this study was to compare the efficacy and safety of diclofenac-gentamicin (DR 1352/1) combination eye drops with gentamicin eye drops in the postoperative management of patients undergoing extracapsular cataract surgery and lens implantation. This was a prospective, randomised, double-masked, parallel-group, four-week, multicentre study with patient visits preoperatively, on the day of surgery, and postoperatively on days 1, 5-8, 12-16, and 26-32. Of the 196 patients (diclofenac-gentamicin 99, gentamicin 97) recruited into the study, 161 (diclofenac-gentamicin 83, gentamicin 78) were available for per-protocol analyses. The two treatment groups were clinically similar at baseline. On days 12-16 postoperatively, diclofenac-gentamicin was significantly more effective (p = 0.002) than gentamicin in reducing intraocular inflammation as assessed by the sum of grades of anterior chamber cells and flare. The level of conjunctival hyperaemia was significantly less in the diclofenac-gentamicin group compared with the gentamicin group on postoperative days 5-8 and 12-16. There was no significant difference between the two study groups in the global assessment of local tolerance. Possibly drug-related adverse events were slightly more in the diclofenac-gentamicin group (22,22%) compared with gentamicin (17,17%); however, all affected study patients normalised with appropriate therapy except one patient with endophthalmitis. In conclusion, diclofenac-gentamicin (DR1352/1) eye drops were more effective than gentamicin eye drops and appeared to be as safe in the control of post-cataract surgery inflammation.
本研究的目的是比较双氯芬酸 - 庆大霉素(DR 1352/1)复方滴眼液与庆大霉素滴眼液在白内障囊外摘除术及晶状体植入术后患者管理中的疗效和安全性。这是一项前瞻性、随机、双盲、平行组、为期四周的多中心研究,患者在术前、手术当天以及术后第1天、第5 - 8天、第12 - 16天和第26 - 32天进行访视。在纳入研究的196例患者(双氯芬酸 - 庆大霉素组99例,庆大霉素组97例)中,161例(双氯芬酸 - 庆大霉素组83例,庆大霉素组78例)可用于符合方案分析。两个治疗组在基线时临床情况相似。术后第12 - 16天,通过前房细胞和闪光分级总和评估,双氯芬酸 - 庆大霉素在减轻眼内炎症方面比庆大霉素显著更有效(p = 0.002)。与庆大霉素组相比,双氯芬酸 - 庆大霉素组在术后第5 - 8天和第12 - 16天结膜充血水平显著更低。在局部耐受性的整体评估中,两个研究组之间没有显著差异。与庆大霉素组(17,17%)相比,双氯芬酸 - 庆大霉素组可能与药物相关的不良事件略多(22,22%);然而,除1例患有眼内炎的患者外,所有受影响的研究患者经适当治疗后均恢复正常。总之,双氯芬酸 - 庆大霉素(DR1352/1)滴眼液比庆大霉素滴眼液更有效,并且在控制白内障术后炎症方面似乎同样安全。