曲安奈德前房注射抑制抗青光眼联合白内障手术后前葡萄膜炎的临床观察

目的观察曲安奈德（TA）前房注射抑制抗青光眼联合白内障手术后前葡萄膜炎症反应的临床效果，探讨TA在抗青光眼联合白内障摘出术中的应用价值。方法42例（42眼）患者由同一医师完成抗青光眼联合白内障摘出术。对照组21例（21眼）行抗青光眼联合白内障摘出术，术毕给予地塞米松2．5mg结膜下注射；实验组21例（2l眼）行抗青光眼联合白内障摘出术，术毕前房内注射2mgTA。观察术后第1、3、7天视力、前房炎症反应及眼压情况。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（x。=10．857，P=0．028；x2=8．467，P=0．037；x2=11．286，P=0．004）。实验组术后第1、3、7天眼压分别为（19．12±3．27）、（17．06±2．90）、（13．05±1．66）mmHg，对照组相应时间点分别为（19．49±3．23）、（17．91±1．95）、（13．67±1．68）mmHg，2组相应时间点眼压比较差异均无统计学意义（t=0．469，P=0．644；t=1．257，P=0．223；t=1．201，P=0．237）。术后早期2组均有轻度角膜水肿，4d左右恢复正常。结论TA可以抑制抗青光眼联合白内障手术后早期前葡萄膜炎症反应，无明显不良反应。

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

Background Anterior uveitis is a common complication following the combination procedure of cataract extraction and anti-glaucoma surgery.More and more researches demonstrated the anti-inflammatory effectiveness of intraocular injection of triamcinolone acetonide (TA).Objective This study aims to observe the anti-inflammatory effectiveness of anterior chamber injection of TA for anterior uveitis following cataract extraction combined with anti-glaucoma surgery.Methods This is a case-control study.The clinical data from 42 eyes of 42 cases underwent the combination surgery of catarat extraction and anti-glaucoma was retrospectively reviewed and analyzed.The operation was performed by the same ophthalmologist on all patients.Twenty-one eyes (21 case) receiving conjunctiva injection of dexamethasone (Dex) in intraoperation served as the control group and the matched cases who received anterior chamber injections of TA in intraoperation were regarded as the TA group.The anterior uveitis was graded according to the Standard of Yang~(3]),and the intraocular pressure(IOP) was measured 1,3,and 7 days after surgery.Written informed consent was obtained from each patient before the initiation of any study protocol.Results The numbers of eyes with severe anterior uvetitis were significantly decreased 1,3,7 days after operation in the TA group in comparison with the Dex group (χ~2=10.857,P=0.028;χ~2=8.467,P=0.037;χ~2=11.286,P=0.004 ).No significant differences were found in IOP values between the TA group and the Dex group 1,3,7 days after operation (19.12±3.27 versus 19.49±3.23mmHg,t=0.469,P=0.644;17.91±1.95 versus 17.06±2.90mmHg,t=1.257,P=0.223;13.67±1.68 versus 13.05±1.66mmHg,t=1.201,P=0.237,respectively).Mild edema of corneal endothelium was seen in the early stage after operation and dissipated 4 days later in both groups,no significant differences were found between the TA group and the Dex group (P＞0.05).Conclusion TA can effectively inhibit the inflammatory reaction of anterior uvea after cataract combination with anti-glaucoma surgery.No severe adverse effect is found after anterior chamber injection of TA.