术前局部非甾体类抗炎药对小切口白内障手术维持瞳孔散瞳效果的研究

Md Emdad Hussain
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摘要

2021年7月至2022年6月,在孟加拉国海军舰艇Patenga号上进行了一项前瞻性、随机、双盲、单中心比较研究,以评估小切口白内障手术期间预防性术前局部给药非甾体抗炎药维持瞳孔散光的临床益处和有效性。随机选取30例小切口白内障手术合并晶状体植入术患者,比较外用非甾体抗炎药滴剂(a组)和安慰剂滴剂(b组)维持术中泪液的效果。所有患者均使用含非防腐剂肾上腺素的平衡盐溶液。在角膜切开前和手术完成后分别测量瞳孔大小。比较两组患者手术前后瞳孔直径的变化情况。手术结束时,两组患者瞳孔大小的变化有显著差异。两组在手术开始时的平均垂直直径和水平直径接近。人工晶状体植入术后,非甾体抗炎药组瞳孔垂直直径(P=0.003)和水平直径(P=0.008)均大于非甾体抗炎药组。局部非甾体抗炎药已被证明在每次手术无并发症的小切口白内障手术中是更有效的减数分裂抑制剂,并且与安慰剂组相比,在手术期间提供更稳定的散体效果。《中国医学杂志》2023年1月12期01期P: 22-26
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Study on the Effect of Topical Pre-operative Nonsteroidal Anti-inflammatory Drugs in Maintaining Mydriasis during Small Incision Cataract Surgery
A prospective, randomized, double masked, single centered comparative study done in the Bangladesh Naval Ship Patenga, Chattogram, Bangladesh, from July 2021 to June 2022, to assess the clinical benefits and effectiveness of prophylactic pre-operative topical administration of NSAIDs in maintaining mydriasis during small incision cataract surgery. Thirty patients underwent small incision cataract surgery with intra ocular lens implantation were randomized to compare the efficacy of topical NSAIDs drops (Group-A) and placebo drops (Group-B) in maintaining peroperative mydriasis. Balanced salt solution containing non preservative adrenaline was used in all patients. Pupil size was measured prior to the corneal incision and after the completion of the operation. The two groups were analyzed with respect to the changes in pupillary diameter at the beginning and at the end of the operation. The change in pupil size was significantly different among the two groups at the end of the surgery. The mean vertical and horizontal diameter of the two groups were near about similar at the beginning of the surgery. Significant differences were seen after IOL implantation with the NSAIDs group having the larger mean diameter in both vertical (P=0.003) and horizontal (P=0.008) pupillary measurements at the conclusion of surgery. Topical NSAIDs has been shown to be a more effective inhibitor of meiosis during per operative uncomplicated small incision cataract surgery and provides a more stable mydriatic effect during surgery compared to the placebo group. CBMJ 2023 January: Vol. 12 No. 01 P: 22-26
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