标题：地塞米松结膜下注射治疗白内障行超声乳化联合人工晶体植入术后中重度角膜水肿疗效观察

      作者：周慧兰，周灵，邓水凤，张碧玉，戴丹    惠州市第三人民医院眼科，广东 惠州 516001

      卷次： 2021年32卷5期

      【摘要】 目的 观察地塞米松结膜下注射治疗白内障行超声乳化联合人工晶体植入术后中重度角膜水肿的疗效。方法 选取2019年1月至2020年4月期间在惠州市第三人民医院眼科因白内障行超声乳化联合人工晶体植入术后中重度角膜水肿的100例患者作为研究对象，按照随机数表法将其分为研究组和对照组各50例。对照组患者采用常规治疗，研究组患者在对照组治疗的基础上给予地塞米松结膜下注射。术前和术后7 d后记录两组患者的眼压、视力、前房深度指标的变化以及术后自觉症状好转时间、角膜水肿消退时间、角膜水肿厚度及治疗效果。结果 术后7 d，研究组患者的治疗总有效率为96.0%，明显高于对照组的86.0%，差异有统计学意义(P<0.05)；研究组患者的自觉症状好转时间、角膜水肿消退时间分别为(4.2±1.1) d、(6.2±1.6) d，明显短于对照组的(6.7±1.4) d、(10.4±2.5) d，差异均有统计学意义(P<0.05)；术前、术后 1 d，两组患者的角膜水肿厚度比较差异无统计学意义(P>0.05)，术后7 d，研究组患者的角膜水肿厚度为(487.32±25.13) μm，明显低于对照组的(516.43±36.21) μm，差异有统计学意义(P<0.05)；术前，两组患者的眼压、视力指标比较差异无统计学意义(P>0.05)，术后，两组患者的眼压均有明显缓解，视力均有明显升高，且研究组治疗后的眼压、视力明显高于对照组，差异均有统计学意义(P<0.05)。结论 地塞米松结膜下注射治疗白内障行超声乳化联合人工晶体植入术后中重度角膜水肿，治疗效果良好，可加快水肿消退，具有临床应用价值。
      【关键词】 白内障；地塞米松；超声乳化；人工晶体植入术；角膜水肿；疗效
      【中图分类号】 R776.1 【文献标识码】 A 【文章编号】 1003—6350（2021）05—0621—04

Effect of dexamethasone subconjunctival injection in the treatment of moderate and severe corneal edema afterphacoemulsification and intraocular lens implantation.
ZHOU Hui-lan, ZHOU Ling, DENG Shui-feng, ZHANGBi-yu, DAI Dan. Huizhou Third People's Hospital, Huizhou 516001, Guangdong, CHINA
【Abstract】 Objective To study the effect of dexamethasone subconjunctival injection in the treatment of mod-erate and severe corneal edema after phacoemulsification and intraocular lens implantation. Methods From January2019 to April 2020, 100 patients with moderate to severe corneal edema after phacoemulsification combined with intra-ocular lens implantation, who admitted to Department of Ophthalmology, Huizhou Third People's Hospital from January2019 to April 2020, were selected and divided into study group and control group according to random number tablemethod, with 50 patients in each group. The control group was given conventional treatment, and the study group wasgiven dexamethasone subconjunctival injection on the basis of the control group. Intraocular pressure (IOP), visual acu-ity (VA), anterior chamber depth (ACD) of the two groups were recorded before operation and 7 days after operation, aswell as the improvement time of conscious symptoms, the regression time of corneal edema, the thickness of corneal ede-ma and the therapeutic effect. Results Seven days after operation, the total effective rate of the study group was 96.0%,which was significantly higher than 86.0% of the control group (P<0.05); the improvement time of self-conscious symp-toms and the regression time of corneal edema in the study group were (4.2±1.1) d, (6.2±1.6) d, respectively, which weresignificantly shorter than corresponding (6.7±1.4) d and (10.4±2.5) d in the control group (P<0.05); there was no signifi-cant difference in corneal edema thickness between the two groups before and 1 day after operation (P>0.05). On the 7thday after operation, the corneal edema thickness of the study group was (487.32±25.13) μm, which was significantly low-er than (516.43±36.21) μm of the control group (P<0.05). Before operation, there was no significant difference in intraoc-ular pressure and visual acuity between the two groups (P>0.05), after operation, the intraocular pressure and visual acu-ity of the two groups were significantly improved, and the IOP and visual acuity of the study group after treatment weresignificantly higher than those of the control group (all P<0.05). Conclusion The treatment effect of dexamethasonesubconjunctival injection for moderate to severe corneal edema after phacoemulsification combined with intraocular lensimplantation is good, can speed up the regression of edema, has clinical application value.
      【Key words】 Cataract; Dexamethasone; Phacoemulsification; Intraocular lens implantation; Corneal edema; Cu-rative effect