[1]谭舟利,范玮.普拉洛芬对糖尿病患者白内障术后视力和黄斑厚度的影响[J].眼科新进展,2019,39(2):145-148.[doi:10.13389/j.cnki.rao.2019.0033]
　TAN Zhou-Li,FAN Wei.Effect of pranoprofen on visual acuity and macular thickness in patients with diabetes mellitus after cataract surgery[J].Recent Advances in Ophthalmology,2019,39(2):145-148.[doi:10.13389/j.cnki.rao.2019.0033]
点击复制

普拉洛芬对糖尿病患者白内障术后视力和黄斑厚度的影响/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年2期
页码:
145-148
栏目:
应用研究
出版日期:
2019-02-05

文章信息/Info

Title:
Effect of pranoprofen on visual acuity and macular thickness in patients with diabetes mellitus after cataract surgery
作者:
谭舟利; 范玮
610041　四川省成都市，四川大学华西医院眼科
Author(s):
TAN Zhou-Li; FAN Wei
Department of Ophthalmology，West China Hospital of Sichuan University，Chengdu 610041，Sichuan Province，China
关键词:
糖尿病; 白内障; 黄斑水肿; 普拉洛芬; 黄斑厚度
Keywords:
diabetes mellitus; cataract; macular edema; pranoprofen; macular thickness
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2019.0033
文献标志码:
A
摘要:
目的　探讨普拉洛芬对合并糖尿病的白内障超声乳化术后视力及黄斑厚度的影响。方法　前瞻性单中心随机临床观察研究。收集行白内障超声乳化摘出联合人工晶状体植入术的不伴有视网膜病变的糖尿病患者44例（66眼）随机分为两组。对照组术前3 d常规应用左氧氟沙星滴眼液，试验组在对照组的基础上加用普拉洛芬滴眼液。对比手术前后两组最佳矫正视力、黄斑厚度、黄斑水肿情况。必要时对患眼行光学相干断层扫描血管成像（optical coherence tomography angiography,OCTA）检查。结果　两组患者术前基本情况及术中有效超声乳化时间差异均无统计学意义（均为P>0.05）。术后1周，试验组最佳矫正视力为（0.10±0.23）logMAR，对照组为（0.31±0.35）logMAR，两组相比差异有统计学意义（P=0.005），试验组视力优于对照组。术后1个月，试验组黄斑厚度为（249.09±22.89）μm，与术前（241.39±17.42）μm相比差异无统计学意义（P=0.150）；对照组黄斑厚度为（256.70±40.84）μm，与术前（232.80±20.10）μm相比显著增厚，差异有统计学意义（P=0.003）。术后1个月时对照组5眼行OCTA检查，其中3眼可观察到黄斑区微血管瘤和无灌注区，1眼存在明显的黄斑囊样水肿；试验组2眼行OCTA检查，均未见明显微血管瘤及无灌注区。结论　术前应用普拉洛芬可减少术后1个月黄斑区视网膜增厚，有助于术后早期视功能的尽快恢复。
Abstract:
Objective　To investigate the effect of pranoprofen on visual acuity and macular thickness in patients with diabetes mellitus after phacoemulsification.Methods　A prospective,single-center,randomized clinical study.Forty-four diabetic patients (66 eyes) without retinopathy undergoing phacoemulsification combined with intraocular lens implantation were randomly divided into two groups:control group and experimental group.Medication in the control group was routine levofloxacin eye drops 3 days before operation.Medication in the experimental group was administration of levofloxacin eye drops and pranoprofen.Best corrected visual acuity (BCVA),macular thickness,occurrence of macular edema were compared before and after operation between the two groups.Optical coherence tomography angiography（OCTA） was performed on affected eyes if necessary.Results　There was no statistically significant difference in preoperative baseline and intraoperative effective phacoemulsification time between the two groups（both P＞0.05）.One week after operation,BCVA in the experimental group was（0.10±0.23）logMAR while BCVA in control group was (0.31±0.35）logMAR.The difference between the two groups was statistically significant (P=0.005).Visual acuity in the experimental group was better than that in the control group.One month after operation,macular thickness in experimental group was（249.09±22.89）μm,there was no statistically significant differencecompared to preoperative macular thickness(241.39±17.42)μm（P=0.150）.Macular thickness in the control group was（256.70±40.84）μm,which was thicker than preoperative macular thickness (232.80±20.10)μm and the difference was statistically significant （P=0.003）.One month after operation,OCTA were performed on 5 eyes in the control group.Among them,macular microaneurysms and retinal non-perfusion area were observed in 3 eyes,and obvious cystoid macular edema was observed in one eye.OCTA were performed on 2 eyes in the experimental group and there was no obvious microaneurysms and non-perfusion area.Conclusion　Preoperative application of pranoprofen can reduce the macular thickening 1 month after operation and is helpful in rapid recovery of visual function in early postoperative time.

参考文献/References:

［1］　POLLREISZ A，SCHMIDT-ERFURTH U.Diabetic cataract-pathogenesis，epidemiology and treatment［J］.J Ophthalmol，2010，2010：608751.
［2］　EARLY TREATMENT DIABETIC RETINOPATHY STUDY RESEARCH GROUP.Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema.Early treatment diabetic retinopathy study report number 2［J］.Ophthalmology，1987，94（7）：761-774.
［3］　PIRES I，SANTOS A R，NUNES S，LOBO C，CUNHA-VAZ J.Subclinical macular edema as a predictor of progression to clinically significant macular edema in type 2 diabetes［J］.Ophthalmologica，2013，230（4）：201-206.
［4］　BROWNING D J，MCOWEN M D，BOWEN R M，O’MARAH T L.Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography［J］.Ophthalmology，2004，111（4）：712-715.
［5］　ISHIBAZAWA A，NAGAOKA T，TAKAHASHI A，OMAE T，TANI T，SOGAWA K，et al.Optical coherence tomography angiography in diabetic retinopathy：A prospective pilot study［J］.Am J Ophthalmol，2015，160（1）：35-44.
［6］　OZGUR O R，OZKURT Y，KULEKCI Z，EVCIMAN T.The combination of phacoemulsification surgery and intravitreal triamcinolone injection in patients with cataract and diabetic macular edema［J］.Saudi J Ophthalmol，2016，30（1）：33-38.
［7］　KESSEL L，TENDAL B，JRGENSEN K J，ERNGAARD D，FLESNER P，ANDRESEN J L，et al.Post-cataract prevention of inflammation and macular edema by steroid and nonsteroidal anti-inflammatory eye drops：a systematic review［J］.Ophthalmology，2014，121（10）：1915-1924.
［8］　KIM S J，EQUI R，BRESSLER N M.Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography［J］.Ophthalmology，2007，114（5）：881-889.
［9］　NEUBAUER A S，PRIGLINGER S，ULLRICH S，BECHMANN M，THIEL M J，ULBIG M W，et al.Comparison of foveal thickness measured with the retinal thickness analyzer and optical coherence tomography［J］.Retina，2001，21（6）：596-601.
［10］　KIM S J，SCHOENBERGER S D，THORNE J E，EHLERS J P，YEH S，BAKRI S J.Topical nonsteroidal anti-inflammatory drugs and cataract surgery：a report by the American academy of ophthalmology［J］.Ophthalmology，2015，122（11）：2159-2168.
［11］　CHEN W，LIN H T，WU C R，XIE C F，HUANG X K，CHEN W R.Clinical research of anterior chamber inflammation after phacoemulsification surgery in patients with complicated cataract secondary to uveitis［J］.Chin J Ophthalmol，2013，49（3）：212-216.
［12］　HONG T，MITCHELL P，DE LORYN T，ROCHTCHINA E，CUGATI S，WANG J J.Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery［J］.Ophthalmology，2009，116（8）：1510-1514.
［13］　SUZUKI N，HIRANO Y，YOSHIDA M，TOMIYASU T，UEMURA A，YASUKAWA T，et al.Microvascular abnormalities on optical coherence tomography angiography in macular edema associated with branch retinal vein occlusion［J］.Am J Ophthalmol，2016，161(2)：126-132.

相似文献/References:

[1]丁文君 韦琦 梁皓 陈金卯 李霞 谭少健.糖尿病兔后发性白内障发生过程中晶状体上皮细胞增殖的变化[J].眼科新进展,2012,32(1):000.
[2]陈放 徐珊 吕伟红 程宏 张洪泉.糖尿病大鼠视网膜的氧化应激损伤及葛根素对其的干预作用[J].眼科新进展,2012,32(1):000.
[3]乔建治 张永喜.抗青光眼术后白内障行不同切口超声乳化术的临床疗效分析[J].眼科新进展,2012,32(4):000.
[4]李晓艳 张卯年.褪黑素对糖尿病大鼠早期视网膜神经细胞凋亡的影响[J].眼科新进展,2012,32(6):000.
[5]吴星.年龄相关性白内障患者超声乳化手术前后对比敏感度分析[J].眼科新进展,2012,32(6):000.
[6]王勇 叶应嘉 鲍先议 周龑丽 许荣 彭婷婷 曾志富.同轴微小切口超声乳化吸出术在青光眼滤过术后白内障摘出术中的应用[J].眼科新进展,2012,32(7):000.
[7]徐威.注射器针头囊袋内吸附劈核法在白内障手术中的应用[J].眼科新进展,2012,32(7):000.
[8]冉文瑛 陈静 张树利.抗青光眼术后不同角膜切口白内障超声乳化术对角膜屈光状态的影响[J].眼科新进展,2012,32(7):000.
[9]王运.常规连续模式超声乳化术与爆破模式冷超声乳化术治疗白内障的临床疗效比较[J].眼科新进展,2012,32(11):000.
[10]郭照洪 王宏 宋爱平 文译 侯祺 解柳.超声乳化白内障摘出联合人工晶状体植入治疗超高度轴性近视白内障患者的临床疗效[J].眼科新进展,2013,33(1):000.
[11]赵恳.白内障超声乳化人工晶状体植入术对糖尿病患者角膜内皮细胞形态与功能的影响[J].眼科新进展,2013,33(4):000.
[12]张立新 崔颖 孟倩丽 张敏 罗中伶 刘辉焜 朱国平 香淦媚 刘清洋 郭海科 郑洋 蔡晶晶. 广东省东莞市2型糖尿病患者盲与低视力患病率及原因分析[J].眼科新进展,2014,34(1):046.
[13]李宝海,陈媛媛,周健. 内质网应激对糖尿病小鼠晶状体上皮细胞发生上皮间质转分化的作用[J].眼科新进展,2015,35(3):205.[doi:10.13389/j.cnki.rao.2015.0056]
　LI Bao-Hai,CHEN Yuan-Yuan,ZHOU Jian. Effects of endoplasmic reticulum stress on EMT of lens epithelial cells in diabetic mice[J].Recent Advances in Ophthalmology,2015,35(2):205.[doi:10.13389/j.cnki.rao.2015.0056]
[14]沈盛县,严宏. 糖尿病性白内障与视网膜病变联合治疗的时机和策略[J].眼科新进展,2015,35(8):791.[doi:10.13389/j.cnki.rao.2015.0218]
　SHEN Sheng-Xian,YAN Hong. Timing and strategy of combined treatment for cataract and retinopathy in diabetic patients[J].Recent Advances in Ophthalmology,2015,35(2):791.[doi:10.13389/j.cnki.rao.2015.0218]
[15]谢驰,方芳,方严.2型糖尿病与白内障术后干眼相关性的临床分析[J].眼科新进展,2017,37(8):773.[doi:10.13389/j.cnki.rao.2017.0196]
　XIE Chi,FANG Fang,FANG Yan.Clinical analysis on T2DM and xerophthalmia after cataract surgery[J].Recent Advances in Ophthalmology,2017,37(2):773.[doi:10.13389/j.cnki.rao.2017.0196]
[16]周?莉,张红.飞秒激光辅助的白内障手术对2型糖尿病患者术中房水细胞因子表达的影响[J].眼科新进展,2018,38(8):786.[doi:10.13389/j.cnki.rao.2018.0186]
　ZHOU Yan-Li,ZHANG Hong.Effects of femtosecond laser assisted cataract surgery on the expression of aqueous cytokine in patients with type 2 diabetes mellitus[J].Recent Advances in Ophthalmology,2018,38(2):786.[doi:10.13389/j.cnki.rao.2018.0186]
[17]徐涛涛,徐国旭.白内障超声乳化术后重度非增生型糖尿病视网膜病变患者视网膜功能变化：基于多焦视网膜电图的观察[J].眼科新进展,2019,39(12):1162.[doi:10.13389/j.cnki.rao.2019.0267]
　XU Tao-Tao,XU Guo-Xu.Changes in retinal function severe non-proliferative diabetic retinopathy patients undergoing phacoemulsification surgery based on multifocal electroretinogram[J].Recent Advances in Ophthalmology,2019,39(2):1162.[doi:10.13389/j.cnki.rao.2019.0267]

备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81371023）
更新日期/Last Update: 2019-02-18