曲安奈德前房注射在青光眼联合白内障手术中的临床疗效观察

目的观察曲安奈德（TA）前房注射对急性闭角型青光眼患者青光眼联合白内障手术后眼内反应的影响，探讨TA在青光眼联合白内障摘出手术中的应用价值。方法36例（36只眼）急性闭角型青光眼患者由同一医师完成青光眼联合白内障手术。对照组18例（18只眼）行青光眼联合白内障手术，实验组18例（18只眼）行青光眼联合白内障手术，术毕前房内注射1mg TA。观察术后第1、3、7天视力、前房炎症反应情况和术后1、3、7天、2周、1个月眼压以及术前、术后1周、2周、1个月角膜内皮计数。结果术后第1、3、7天前房反应实验组明显低于对照组，差异均有统计学意义。术后第1、3、7天、2周、1个2组相应时间点眼压比较差异均无统计意义。术前及术后1周、2周、1个月实验组及对照组角膜内皮计数差异无统计意义。术后早期2组均有轻度角膜水肿，7d左右恢复正常。结论TA可以抑制急性闭角型青光眼患者青光眼联合白内障手术后早期眼内炎症反应，缩短术后恢复时间，无明显不良反应。

Clinical observation of injection of triamcinolone acetonide into the anterior chamber after cataract combined with anti-glaucoma surgery

Objective This study aims to observe the anti-inflammatory effectiveness of anterior chamber injection of triamcinolone acetonide(TA)for anterior uveitis following cataract extraction combined with anti-glaucoma surgery in acute angle-closure glaucoma.Methods This is a case-control study.The clinical data from 36 eyes of 36 cases underwent the combination surgery of cataract extraction and anti-glaucoma was retrospectively reviewed and analyzed the operation was performed by the same ophthalmologist on all patients.Thirty-six eyes(36 case) were divided into two groups:experimental group was injected TA 1 mg in anterior chamber and control group was without TA in anterior chamber in intraoperation.The anterior chamber exudation and visual acuity were observed in two groups 1,3 and 7 days after surgery;the intraocular pressure(IOP)was measured 1,3 and 7 days,2 weeks,1month after surgery;corneal endothelia densitiy was measured 1,2weeks,and 1month after surgery.Results The numbers of eyes with severe anterior uveitis were significantly decreased 1,3,7days after operation experimental group in comparition with control group.No significant differences were found in IOP values between the experimental group and control group 1,3,7days,two weeks and 1months after operation.There was no statistical difference in corneal endothelial density after operation in two groups.Edema of corneal endothelium was seen in the early stage after operation and dissipated 7days later in both groups.No significant differences were found between the experimental group and control group.Conclusion TA can effectively inhibit the inflammatory reaction of anterior uveitis after cataract combination with anti-glaucoma surgery.No severe adverse effect is found after anterior chamber injection of TA.