前房注射地塞米松在抗青光眼联合白内障手术中的应用

目的:观察抗青光眼联合白内障手术中前房注射地塞米松对术后前葡萄膜炎症反应的抑制作用。方法:选取2008-09/2010-10行抗青光眼联合白内障手术的患者46例46眼,随机分成试验组(地塞米松组)和对照组,每组均23例,两组均行抗青光眼联合白内障手术。试验组术中前房注入地塞米松注射液0.5mg,对照组术中前房注入复方平衡盐溶液0.5mg。观察术后1,3,7d;1,3mo视力、前房房水闪辉情况、眼压及角膜内皮细胞计数情况。结果:术后第1,3,7d前房房水闪辉试验组明显低于对照组,差异均有统计学意义(P<0.05)。术后1,3mo均无房水闪辉出现。试验组与对照组相应时间点眼压比较差异均无统计学意义(P>0.05)。试验组与对照组角膜内皮细胞数比较,差异均无统计学意义(P>0.05)。结论:抗青光眼联合白内障手术中前房注射地塞米松可抑制术后早期前葡萄膜炎炎症反应,无严重并发症发生,是一种安全、有效的方法。

The adhibition of injecting dexamethasone into the anterior chamber in anti-glaucoma with cataract surgery

AIM: To observe the anti-inflammatory effectiveness of anterior chamber injection of dexamethasone for anterior uveitis following cataract extraction combined with anti-glaucoma surgery.

METHODS: Forty-six patients who received combination procedure of cataract extraction and anti-glaucoma from September 2008 to October 2010 were randomly divided into two groups: treatment group and control group. Each group had 23 patients. All patients were performed using combination procedure of cataract extraction and anti-glaucoma. During surgery, the treatment group received anterior chamber injection of dexamethasone(0.5mg). The control group was applied with anterior chamber injection of balanced salt solution(0.5mg). The myopia, aqueous flare,intraocular pressure(IOP)and corneal endothelium counter was measured 1 day, 3,7 days,1 month and 3 months after surgery.

RESULTS: At 1, 3 and 7 days after surgery, the aqueous flare in treatment group was significantly lower than control group(P<0.05). There was no aqueous flare at 1 month and 3 months after surgery. The intraocular pressure between two groups was not statistically different(P>0.05). Meanwhile, no significant difference was found between two groups when determined the corneal endothelium counter.

CONCLUSION: Dexamethasone can effectively inhibit the inflammatory reaction of anterior uveitis after cataract combination with anti-glaucoma surgery. No severe applications is found after anterior chamber injection of dexamethasone.In all, it was a safe and effective method.