白内障手术术后早期抗炎治疗效果评估

M. M. Bikbov, E. L. Usubov, G. M. Kazakbayeva, A. U. Galimov, N. I. Pokhilko, I. Valishin, A. M. Nizamutdinova
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摘要

目的:评估非甾体抗炎药(NSAIDs)单药治疗以及与糖皮质激素联合治疗预防白内障超声乳化术后炎症的有效性和安全性。研究包括 75 名接受白内障超声乳化术并植入后房型人工晶体的患者。根据抗炎治疗的不同将患者分为以下几组:A1组--奈帕芬胺(Nepafenac-Optic),A2组--溴芬胺(Broxinac),A3组--地塞米松(Dexamethasone),B1组--奈帕芬胺(Nepafenac-Optic)+地塞米松,B2组--溴芬胺+地塞米松。术后炎症通过结膜充血、疼痛、廷德尔效应和黄斑区视网膜厚度的严重程度进行评估。奈帕芬胺组(A1)与 A2 和 A3 组相比,疼痛症状的严重程度分别降低了 49% 和 74%。与廷德尔效应有很强的直接相关性,这在 A3 组更为明显,达到 0.73 点。术后早期,A2 组和 A3 组的黄斑区视网膜厚度有所增加,平均增加了 30 微米。在非帕芬酸光学组和与 GCS 联合治疗组中,视网膜厚度保持稳定。A2 组和 A3 组在术后早期出现黄斑囊性水肿,分别为 2.6% 和 1.3%。结论:白内障手术治疗后,患者的眼压会有所下降。白内障手术治疗后,与单用溴芬酸或地塞米松相比,奈帕芬胺 Optic 能明显缓解疼痛综合征。奈帕芬胺 Optic 有助于减轻眼球前后节段炎症的严重程度,将术后黄斑区视网膜厚度的变化降至最低。这些效果的严重程度与非甾体抗炎药+ GCS 的联合疗法相当。奈帕芬胺 Optic 不会增加眼压,与糖皮质激素联合用药相比具有更高的安全性,并能降低术后并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of anti-inflammatory therapy effectiveness in the early postoperative period of cataract surgery
Purpose: To evaluate the efficacy and safety of nonsteroid anti-inflammatory drugs (NSAIDs) in monotherapy and as part of combination therapy with glucocorticosteroids for the prevention of postoperative inflammation after cataract phacoemulsification.Material and methods. The study included 75 patients who underwent phacoemulsification with implantation of a posterior chamber intraocular lens. Patients were divided into groups depending on anti-inflammatory treatment: A1 — nepafenac (Nepafenac-Optic), A2 — bromfenac (Broxinac), A3 — dexamethasone (Dexamethasone), B1 — Nepafenac-Optic + dexamethasone, B2 — bromfenac + Dexamethasone. Postoperative inflammation was assessed by the severity of conjunctival hyperemia, pain, Tyndall effect and retinal thickness in the macular region.Results. The severity of the pain symptom was lower in the nepafenac group (A1) as compared to groups A2 and A3 by 49 and 74 %, respectively. A strong direct correlation with the Tyndall effect was revealed, which was more pronounced in group A3 and amounted to 0.73 points. An increase in the thickness of the retina in the macular region in the early stages after surgery was observed in groups A2 and A3, on average by 30 microns. In the groups of Nonpafenac Optic and combined therapy with GCS, the thickness of the retina remained stable. Cystic macular edema in the early postoperative period was observed in groups A2 and A3 and amounted to 2.6 and 1.3 %, respectively. There was a tendency to higher IOP rates in the GCS therapy groups.Conclusion. After surgical treatment of cataracts, the Nepafenac Optic significantly relieves the pain syndrome, as compared with monotherapy with bromfenac or dexamethasone. Nepafenac-Optic helps to reduce the severity of inflammation in the anterior and posterior segments of the eye, minimizes the changes in the retinal thickness of the macular region in the postoperative period. The severity of these effects is comparable to the combination therapy of NSAIDs + GCS. Nepafenac-Optic does not increase IOP, has a more favorable safety profile than in combinations with glucocorticosteroids, and reduces the risk of postoperative complications.
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