摘要
目的探讨雷珠单抗联合地塞米松缓释剂对糖尿病性白内障术后黄斑水肿的预防及黄斑中心凹视网膜厚度和黄斑中心凹下脉络膜厚度的影响。方法前瞻性随机对照研究。研究对象2020年6月至2022年1月收治于我院的112例(134只眼)糖尿病性白内障患者。随机数字表法将112例患者分为研究组(56例)和对照组(56例),两组患者均实施超声乳化白内障吸除术(PHACO)联合人工晶状体植入术(IOL)治疗。对照组使用地塞米松缓释剂进行玻璃体内注射治疗,研究组在对照组基础上给予雷珠单抗玻璃体腔注射治疗。比较两组患者手术前后平均最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度、黄斑总容积、黄斑水肿发生情况和黄斑中心凹下脉络膜厚度。结果两组患者术前基线资料比较差异均无统计学意义(均P>0.05);重复测量方差分析结果显示,两组患者平均BCVA、黄斑中心凹视网膜厚度、黄斑总容积和黄斑中心凹下脉络膜厚度术后不同时间点差异均有统计学意义(均P<0.05),不同组别之间差异有统计学意义(均P<0.05),不同时间与组别之间有交互作用(均P<0.05),且研究组患者手术后各项指标均低于对照组(均P<0.05);研究组患者术后共发生黄斑水肿10例(17.86%)低于对照组患者31例(55.36%)(P<0.05)。两组患者术后均无不良药物反应出现。结论雷珠单抗联合地塞米松缓释剂能够降低糖尿病性白内障术后黄斑水肿的发生率,并减缓黄斑中心凹视网膜厚度和黄斑中心凹下脉络膜厚度增加,对术后患眼视力恢复具有一定帮助。
Objective To investigate the effect of Ranibizumab combined with dexamethasone sustained release on the prevention of macular edema after diabetic cataract surgery and the thickness of macular fovea retina and choroid thick⁃ness under macular fovea.Methods Prospective single⁃center randomized study.Participants A total of 112 patients(134 eyes)with diabetic cataract were admitted to our hospital.112 patients were divided into study group(56 cases)and con⁃trol group(56 cases)by random number table method.Both groups were treated with phacoemul sification combined with intraocular lens implantation.The control group received intravitreal injection of dexamethasone sustained release agent,and the study group received intravitreal injection of Ranibizumab on the basis of the control group.The average best cor⁃rected visual acuity(BCVA),macular foveal retinal thickness,macular volume,macular edema and subfoveal choroidal thickness before and after operation were compared between the two groups.Results There was no significant difference in preoperative baseline data between the two groups(all P>0.05).Repeated measurement ANOVA results showed that the mean BCVA,macular foveal retinal thickness,macular total volume and macular subfoveal choroid thickness of the two groups were statistically significant at different time points after surgery(all P<0.05),and the differences among different groups were statistically significant(all P<0.05).There was an interaction between different time and groups(all P<0.05),and all indexes in the study group were lower than those in the control group(all P<0.05).The total incidence of macular edema in the study group(10 cases,17.86%)was significantly lower than that in the control group(31 cases,55.36%)(P<0.05).There were no adverse drug reactions in the two groups.Conclusions Ranibizumab combined with dexamethasone sustained release agent can reduce the incidence of macular edema after diabetic cataract surgery,and slow down the increase of macular fovea retinal thickness and the thickness of the choroid under macular fovea,which is helpful for postoperative visual recovery of the affected eye。
作者
黄鸣宇
罗昊敏
段国平
Huang Mingyu;Luo Haomin;Duan Guop-ing(Department of Ophthalmology,The First Affiliated Hospital of Hunan Normal University/Department of Ophthalmology,Hunan Provincial People's Hospital,Changsha,Hunan 410000,China)
出处
《临床眼科杂志》
2023年第6期514-519,共6页
Journal of Clinical Ophthalmology
作者简介
通讯作者:段国平(Email:Dgp123004@sina.com)。
