摘要
目的探讨行玻璃体腔0.7mg地塞米松缓释剂(Ozurdex■)植入术治疗因多种病因行玻璃体切除手术,术后继发黄斑水肿患者的临床疗效及并发症分析。方法本研究为回顾性病例系列研究,共15例患者(16只眼)纳入本研究,男7例(8只眼)、女8例(8只眼),年龄47~72(60.2±8.6)岁。其中糖尿病视网膜病变8例(6例联合白内障手术)、视网膜脱离硅油取出术后4例(均联合白内障手术)、黄斑前膜2例(均联合白内障手术)、玻璃体积血1例(联合白内障手术)。均因玻璃体切除术后继发黄斑水肿,行玻璃体腔Ozurdex■植入术。植入次数1~3(1.67±0.79)次,随访时间3~12(7.33±3.50)个月。结果15例(16只眼)于Ozurdex■植入术后3个月内最佳矫正视力(BCVA)提高者10例(11只眼)、BCVA不变者4例(4只眼)、BCVA降低者1例(1只眼)。术后黄斑水肿均明显改善,光学相干断层扫描(OCT)测量黄斑中心凹厚度(CMT)术前350~1370(621.60±235.48)γm,术后118~556(269.87±118.14)γm,差异有统计学意义(P<0.001)。术后白内障无明显进展。7例黄斑水肿复发,再次Ozurdex®植入1~2次稳定。术后眼压升高者3例,于药物植入术后1~2个月发生,眼压最高值36 mmHg,均局部降眼压药物控制。2例药物进入前房,其中1例药物取出。结论玻璃体腔Ozurdex■植入术效果确切,并发症可控,是一种安全有效的治疗玻璃体切除术后继发黄斑水肿的方法。
Objective To investigate the efficiency,safety and complication of 0.7 mg dexamethasone sustained release agent(Ozurdex■)vitreous cavity implantation for macular edema secondary to vitrectomy.Methods A total of 15 patients(16 eyes)were included in this retrospective case series study.There were 7 males(8 eyes)and 8 females(8 eyes).Age ranged from 47 to 72 years old with an average age of(60.2±8.6)years.Among them,8 cases were diabetic retinopathy(6 cases combined cataract surgery).4 cases were silicone oil removal after retinal detachment surgery(all combined cataract surgery).2 cases were epi-macular membrane(all combined with cataract surgery)and 1 case was vitreous hemorrhage(combined with cataract surgery).Ozurdex®was implanted for macular edema after vitrectomy.The number of implantation was from 1 to 3 times(mean 1.67 times).The follow-up time was from 3 to 12 months,with an average of(7.33±3.50)months.Results The best corrected visual acuity(BCVA)was improved in 10 cases(11 eyes),unchanged in 4 cases and decreased in 1 case within 3 months after Ozurdex®implantation in the 15 cases(16 eyes).The macular edema was significantly improved in all cases.The central macular thickness(CMT)measured by optical coherence tomography(OCT)was from 350 to 1370γm before surgery with average thickness(621.60±235.48)γm,and the CMT postoperative was 118 to 556γm with average thickness(269.87±118.14)γm,with statistically significant difference(P<0.001).Cataract was not progressive after Ozurdex■implantation.Macular edema was recurrent in 7 cases after first implantation and stable for additional 1-2 injections.Intraocular pressure elevation occurred in 3 cases 1 to 2 months after implantation with the highest intraocular pressure of 36 mmHg,which were controlled by local anti-glaucoma eye drops.Drugs entered into the anterior chamber in 2 cases and was taken out in 1 case.Conclusions The efficiency of Ozurdex■vitreous cavity implantation is definite and the complications are controllable,so it is a safe and effective method to treat macular edema after vitrectomy.
作者
张永鹏
贾力蕴
高丽琴
曹绪胜
王聪
马凯
Zhang Yongpeng;Jia Liyun;Gao Liqin;Cao Xusheng;Wang Cong;Ma Kai(Beijing Tongren Hospital,Affiliated of Capital Medical University,Beijing Tongren Eye Center,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China)
出处
《中国医师杂志》
CAS
2022年第1期13-18,共6页
Journal of Chinese Physician
基金
国家自然科学基金(81670738)。
关键词
玻璃体切除术
黄斑水肿
地塞米松
迟效制剂
玻璃体内注射
Vitrectomy
Macular edema
Dexamethasone
Delayed-action preparations
Intravitreal injections
