[1]修立恒,赵静,钱婷丽,等.地塞米松玻璃体内植入剂治疗白内障术后人工晶状体眼黄斑囊样水肿的短期疗效观察[J].眼科新进展,2021,41(12):1175-1178.[doi:10.13389/j.cnki.rao.2021.0245]
　XIU Liheng,ZHAO Jing,QIAN Tingli,et al.Short-term outcomes of dexamethasone intravitreal implant in the treatment of pseudophakic cystoid macular edema after cataract surgery[J].Recent Advances in Ophthalmology,2021,41(12):1175-1178.[doi:10.13389/j.cnki.rao.2021.0245]
点击复制

地塞米松玻璃体内植入剂治疗白内障术后人工晶状体眼黄斑囊样水肿的短期疗效观察/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年12期
页码:
1175-1178
栏目:
应用研究
出版日期:
2021-12-05

文章信息/Info

Title:
Short-term outcomes of dexamethasone intravitreal implant in the treatment of pseudophakic cystoid macular edema after cataract surgery
作者:
修立恒; 赵静; 钱婷丽; 成仲夏
610081　四川省成都市，成都大学附属医院眼科（修立恒，钱婷丽，成仲夏）；550004　贵州省贵阳市，贵州医科大学附属医院眼科（赵静）
Author(s):
XIU Liheng1; ZHAO Jing2; QIAN Tingli1; CHENG Zhongxia1
1.Department of Ophthalmology,Affiliated Hospital of Chengdu University,Chengdu 610081,Sichuan Province,China
2.Department of Ophthalmology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou Province,China
关键词:
地塞米松玻璃体内植入剂; 人工晶状体眼; 黄斑囊样水肿
Keywords:
dexamethasone intravitreal implant;  pseudophakic eye;  cystoid macular edema
分类号:
R774.5
DOI:
10.13389/j.cnki.rao.2021.0245
文献标志码:
A
摘要:
目的　观察地塞米松玻璃体内植入剂（Ozurdex）治疗白内障术后人工晶状体眼黄斑囊样水肿（PCME）的疗效及安全性。方法　回顾性分析14例（16眼）PCME患者的临床资料。所有患眼均接受玻璃体内注射地塞米松玻璃体内植入剂0.7 mg的治疗，治疗后随访6个月，随访期间若发现PCME复发，则再次注射地塞米松玻璃体内植入剂。比较治疗前与治疗后1个月、3个月、6个月患眼最佳矫正视力（BCVA）、眼压及黄斑中心凹视网膜厚度（CMT）等的变化。结果　治疗前及治疗后1个月、3个月、6个月患眼的BCVA（logMAR）分别为0.61±0.17、0.15±0.10、0.14±0.10、0.12±0.10，CMT分别为（540.38±76.10）μm、（229.13±13.27）μm、（227.13±13.32）μm、（225.56±14.88）μm，与治疗前相比，治疗后1个月、3个月及6个月患眼的BCVA均显著改善，CMT均显著降低（均为P<0.001）。治疗前及治疗后1个月、3个月、6个月患眼眼压相比，差异无统计学意义（F=0.751，P=0.087）。随访6个月期间，仅1眼行两次地塞米松玻璃体内植入剂注射治疗；2眼出现眼压轻度升高，给予局部降眼压治疗后恢复正常。所有患者随访期间均未出现与药物、眼部治疗相关的并发症。结论　地塞米松玻璃体内植入剂治疗PCME短期疗效显著。
Abstract:
Objective　To evaluate the efficacy and safety of dexamethasone intravitreal implant (Ozurdex) in the treatment of pseudophakic cystoid macular edema (PCME) after cataract surgery. Methods　The clinical data of 14 patients (16 eyes) with PCME were retrospectively analyzed. All eyes were intravitreally injected with 0.7 mg of dexamethasone intravitreal implant. During the follow-up 6 months, in case of the recurrence of PCME, dexamethasone intravitreal implant was injected again. The best corrected visual acuity (BCVA), intraocular pressure (IOP), and central macular thickness (CMT) were recorded and compared preoperatively, 1 month, 3 months, and 6 months postoperatively. Results　The BCVA (logMAR) before treatment, at 1, 3 and 6 months after treatment was 0.61±0.17, 0.15±0.10, 0.14±0.10, and 0.12±0.10, respectively, and the CMT was (540.38±76.10) μm, (229.13±13.27) μm, (227.13±13.32) μm, and (225.56±14.88) μm, respectively. Compared with the preoperative conditions, the BCVA of all eyes significantly improved and CMT significantly reduced at 1 month, 3 months, and 6 months after treatment (all P<0.001), while the IOP showed no statistical difference (F=0.751, P=0.087). During the 6-month follow-up, only one eye underwent intravitreal injection of dexamethasone twice. IOP increased slightly in two eyes and then returned to normal after IOP-lowering treatment. All patients had no complications related to drug and eye treatment during follow-up. Conclusion　Dexamethasone intravitreal implant has a significant effect in the treatment of PCME in a short time.

参考文献/References:

［1］　IRVINE S R.A newly defined vitreous syndrome following cataract surgery［J］.Am J Ophthalmol,1953,36(5):599-619.
［2］　YOON D H,KANG D J,KIM M J,KIM H K.New observation of microcystic macular edema as a mild form of cystoid macular lesions after standard phacoemulsification:prevalence and risk factors［J］.Medicine,2018,97(15):e0355.
［3］　COPETE S,MART-RODRIGO P,MUIZ-VIDAL R,PASTOR-IDOATE S,RIGO J,FIGUEROA M S,et al.Preoperative vitreoretinal interface abnormalities on spectral domain optical coherence tomography as risk factor for pseudophakic cystoid macular edema after phacoemulsification［J］.Retina,2019,39 (11):2225-2232.
［4］　FLACH A J.The incidence,pathogenesis and treatment of cystoid macular edema following cataract surgery［J］.Trans Am Ophthalmol Soc,1998,96:557-634.
［5］　LONDON N J S,CHIANG A,HALLER J A.The dexamethasone drug delivery system:indications and evidence［J］.Adv Ther,2011,28(5):351-366.
［6］　MYLONAS G,GEORGOPOULOS M,MALAMOS P,GEORGALAS I,KOUTSANDREA C,BROUZAS D,et al.Comparison of dexamethasone intravitreal implant with conventional triamcinolone in patients with postoperative cystoid macular edema［J］.Curr Eye Res,2017,42(4):648-652.
［7］　MAYER W J,KURZ S,WOLF A,KOOK D,KREUTZER T,KAMPIK A,et al.Dexamethasone implant as an effective treatment option for macular edema due to Irvine-Gass syndrome［J］.J Cataract Refract Surg,2015,41(9):1954-1961.
［8］　YONEKAWA Y,KIM I K.Pseudophakic cystoid macular edema［J］.Curr Opin Ophthalmol,2012,23(1):26-32.
［9］　SHELSTA H N,JAMPOL L M.Pharmacologic therapy of pseudophakic cystoid macular edema:2010 update［J］.Retina,2011,31(1):4-12.
［10］　ELSAWY M F,BADAWI N,KHAIRY H A.Prophylactic postoperative ketorolac improves outcomes in diabetic patients assigned for cataract surgery［J］.Clin Ophthalmol,2013,7:1245-1249.
［11］　JONAS J B,KREISSIG I,DEGENRING R F.Intravitreal triamcinolone acetonide for pseudophakic cystoid macular edema［J］.Am J Ophthalmol,2003,136:384-386.
［12］　SPITZER M S,ZIEMSSEN F,YOERUEK E,PETERMEIER K,AISENBREY S,SZURMAN P.Efficacy of intravitreal bevacizumab in treating postoperative pseudophakic cystoid macular edema［J］.J Cataract Refract Surg,2008,34(1):70-75.
［13］　BARONE A,RUSSO V,PRASCINA F,NOCI N D.Short-term safety and efficacy of intravitreal bevacizumab for pseudophakic cystoid macular edema［J］.Retina,2009,29(1):33-37.
［14］　SPITZER M S,ZIEMSSEN F,YOERUEK E,PETERMEIER K,AISENBREY S,SZURMAN P.Efficacy of intravitreal bevacizumab in treating postoperative pseudophakic cystoid macular edema［J］.J Cataract Refract Surg,2008,34(1):70-75.
［15］　KOUTSANDREA C,MOSCHOS M M,BROUZAS D,LOUKIANOU E,APOSTOLOPOULOS M,MOSCHOS M.Intraocular triamcinolone acetonide for pseudophakic cystoid macular edema:optical coherence tomography and multifocal electroretinography study［J］.Retina,2007,27(2):159-164.
［16］　WILLIAMS G A,HALLER J A,KUPPERMANN B D,BLUMENKRANZ M S,WEINBERG D V,CHOU C,et al.Dexamethasone posterior-segment drug delivery system in the treatment of macular edema resulting from uveitis or Irvine-Gass syndrome［J］.Am J Ophthalmol,2009,147(6):1048-1054.
［17］　RANDAZZO A,VINCIGUERRA P.Chronic macular edema medical treatment in Irvine-Gass syndrome:case report［J］.Eur J Ophthalmol,2010,20(2):462-465.
［18］　KALDIRIM H,YAZGAN S,KIRGIZ A,KR AT A,NACARO G LU A.Intravitreal dexamethasone implant in the treatment of pseudophakic cystoid macular edema or irvine-gass syndrome［J］.J Ret-Vit,2020,29(2):105-110.
［19］　GAN I M,UGAHARY L C,DISSEL J T,MEURS J C.Effect of intravitreal dexamethasone on vitreous vancomycin concentrations in patients with suspected postoperative bacterial endophthalmitis［J］.Graefes Arch Clin Exp Ophthalmol,2005,243(11):1186-1189.
［20］　ERRERA M H.Dexamethasone implant versus posterior sub-tenon triamcinolone acetonide for treatment of macular edema and/or vitritis in intraocular inflammatory diseases.Retrospective case series［J］.Acta Ophthalmologica,2014,92(S253):1-3.
［21］　GUCLU H,GURLU V P.Comparison of topical nepafenac 0.1% with intravitreal dexamethasone implant for the treatment of Irvine-Gass syndrome［J］.Int J Ophthalmol,2019,12(2):258-267.
［22］　OHN M T,THOMPSON E,WAGHMARE A,CHANDRA A,KARIA N.Usefulness of intravitreal dexamethasone implant in treatment of persistent cystoid macular edema due to Irvine-Gass syndrome［J］.J Clin Res Ophthalmol,2019,6(1):1-6.
［23］　SUDHALKAR A,CHHABLANI J,VASAVADA A,BHOJWANI D,VASAVADA V,VASAVADA S.Intravitreal dexamethasone implant for recurrent cystoid macular edema due to Irvine-Gass syndrome:a prospective case series［J］.Eye,2016,30,1549-1557.

相似文献/References:

[1]梁婉玲,周怀胜,马海智,等.地塞米松玻璃体内植入剂Ozurdex治疗视网膜静脉阻塞继发黄斑水肿的短期疗效[J].眼科新进展,2019,39(7):666.[doi:10.13389/j.cnki.rao.2019.0153]
　LIANG Wan-Ling,ZHOU Huai-Sheng,MA Hai-Zhi,et al.The short-term efficacy of Ozurdex for macular edema secondary to retinal vein occlusion[J].Recent Advances in Ophthalmology,2019,39(12):666.[doi:10.13389/j.cnki.rao.2019.0153]
[2]徐畅,宋籽浔,王明玥,等.白内障摘出联合人工晶状体（IOL）植入术及无晶状体眼行IOL二期植入术患儿术后眼前节结构特点[J].眼科新进展,2019,39(10):929.[doi:10.13389/j.cnki.rao.2019.0211]
　XU Chang,SONG Zi-Xun,WANG Ming-Yue,et al.Anterior segmental biometry characteristics of children patients following cataract extraction combined with intraocular lens (IOL) implantation or secondary IOL implantation in aphakic eyes[J].Recent Advances in Ophthalmology,2019,39(12):929.[doi:10.13389/j.cnki.rao.2019.0211]
[3]梁沛,王谭,李东辉,等.视网膜分支静脉阻塞相关黄斑水肿不同治疗方案疗效评价[J].眼科新进展,2022,42(10):806.[doi:10.13389/j.cnki.rao.2022.0166]
　LIANG Pei,WANG Tan,LI Donghui,et al.Evaluation on the efficacy of different treatment options for macular edema in patients with branch retinal vein occlusion[J].Recent Advances in Ophthalmology,2022,42(12):806.[doi:10.13389/j.cnki.rao.2022.0166]
[4]杨红伟,侯习武,关微,等.地塞米松玻璃体内植入剂在非感染性葡萄膜炎继发黄斑水肿患者治疗中的作用[J].眼科新进展,2023,43(6):484.[doi:10.13389/j.cnki.rao.2023.0098]
　YANG Hongwei,HOU Xiwu,GUAN Wei,et al.Role of dexamethasone intravitreal implants in the treatment of macular edema secondary to non-infectious uveitis[J].Recent Advances in Ophthalmology,2023,43(12):484.[doi:10.13389/j.cnki.rao.2023.0098]
[5]邓爱萍,田润,熊成,等.地塞米松玻璃体内植入剂早期联合康柏西普在抗血管内皮生长因子治疗反应不佳糖尿病性黄斑水肿中的应用[J].眼科新进展,2023,43(9):722.[doi:10.13389/j.cnki.rao.2023.0145]
　DENG Aiping,TIAN Run,XIONG Cheng,et al.Application of intravitreal dexamethasone implant combined with Conbercept in the treatment of diabetic macular edema with poor response to anti-vascular endothelial growth factor therapy[J].Recent Advances in Ophthalmology,2023,43(12):722.[doi:10.13389/j.cnki.rao.2023.0145]

备注/Memo

备注/Memo:
N/A
更新日期/Last Update: 2021-12-05