标题：曲安奈德在白内障合并重度玻璃体积血PPV术前的应用效果及安全性研究

      作者：李婧媛 1，李淑琴 2，万婧 2    1.咸阳爱尔眼科医院住院部，陕西 咸阳 712000；2.甘肃医学院附属医院眼科，甘肃 平凉 744000

      卷次： 2024年35卷8期

      【摘要】 目的 研究玻璃体腔注射曲安奈德在白内障合并重度玻璃体积血患者超声乳化手术联合玻璃体切除术(PPV)术前的应用效果。方法 选择2020年1月至2022年1月在咸阳爱尔眼科医院确诊的100例(100眼)白内障合并重度玻璃体积血患者作为研究对象，按照随机数表法分为研究组和对照组各50例50只眼(均为单眼)。对照组患者给予超声乳化手术联合PPV治疗，研究组患者的手术方法同对照组，但在术前给予玻璃体腔注射曲安奈德0.05~0.10 mL。比较两组患者术前，术后1周、8周、24周、48周的矫正视力情况与眼压情况，出院前比较两组患者连续撕裂以及人工晶体植入术(IOL)植入囊袋内操作的成功率及后囊膜破裂的发生率。结果 术前两组患者的视力比较差异无统计学意义(P>0.05)；术后1周、8周、24周及48周，两组患者的视力均明显改善，且研究组患者的视力分别为 0.35±0.11、0.48±0.15、0.60±0.18、0.62±0.20，明显优于对照组患者的 0.26±0.08、0.36±0.11、0.47±0.14、0.48±0.16，差异均有统计学意义(P<0.05)；术前两组患者的眼压比较差异无统计学意义(P>0.05)；术后 1周、8周、24周及48周，两组患者的眼压比较差异均无统计学意义(P>0.05)；研究组患者的连续撕裂以及 IOL植入囊袋内操作的成功率分别为100.00%、100.00%，明显高于对照组的86.00%、86.00%，差异均有统计学意义(P<0.05)；研究组患者的后囊膜无破裂发生率为100.00%，明显高于对照组的82.00%，差异具有统计学意义(P<0.05)。结论 玻璃体腔注射曲安奈德在白内障合并重度玻璃体积血患者超声乳化手术联合PPV术前的应用有利于提高手术的疗效，值得临床推广应用。
      【关键词】 白内障；重度玻璃体积血；曲安奈德；超声乳化手术；玻璃体切除手术
      【中图分类号】 R776.1 【文献标识码】 A 【文章编号】 1003—6350（2024）08—1116—04

Application of intravitreal triamcinolone acetonide injection before phacoemulsification combined with parsplana vitrectomy in cataract patients with severe vitreous hemorrhage.
LI Jing-yuan 1, LI Shu-qin 2, WAN Jing 2. 1.Inpatient Department, Xianyang Aier Eye Hospital, Xianyang 712000, Shaanxi, CHINA; 2. Department of Ophthalmology,the Affiliated Hospital of Gansu Medical College, Pingliang 744000, Gansu, CHINA
【Abstract】 Objective To study the effect of intravitreal triamcinolone acetonide injection before phacoemulsi-fication combined with pars plana vitrectomy (PPV) in cataract patients with severe vitreous hemorrhage. Methods Atotal of 100 patients (100 eyes) with cataracts and severe vitreous hemorrhage diagnosed at Xianyang Aier Eye Hospitalfrom January 2020 to January 2022 were selected and randomly divided into a study group and a control group, eachwith 50 cases and 50 eyes (all single eye for the patients), using a random number table method. Patients in the controlgroup were treated with phacoemulsification combined with PPV, while patients in the study group had the same surgicalmethod as the control group but received intravitreal injection of 0.05-0.10 mL of intravitreal triamcinolone acetonide in-jection before surgery. The corrected visual acuity and intraocular pressure were compared between the two groups of pa-tients before surgery, at 1 week, 8 weeks, 24 weeks, and 48 weeks after surgery. The success rates of continuous tearsand intraocular lens implantation (IOL) in the bag operation were compared between the two groups of patients beforedischarge, as well as the incidence of posterior capsule rupture. Results There was no significant difference in the visu-al acuity between the two groups before operation (P>0.05); at 1 week, 8 weeks, 24 weeks, and 48 weeks after surgery,the visual acuity of patients in the study group was significantly improved, and the visual acuity in the study group were0.35±0.11, 0.48±0.15, 0.60±0.18, and 0.62±0.20, which were significantly better than 0.26±0.08, 0.36±0.11, 0.47±0.14,and 0.48±0.16 in the control group, with statistically significant differences (P<0.05). There was no statistically sig-nificant difference in intraocular pressure between the two groups before operation (P>0.05), or at 1 week, 8 weeks,24 weeks, and 48 weeks after operation (P>0.05). The success rates of continuous tear and IOL in the study group were100.00% and 100.00%, which were significantly higher than 86.00% and 86.00% in the control group (P<0.05). The inci-dence of no rupture of posterior capsule in the study group was 100.00%, which was significantly higher than 82.00% inthe control group (P<0.05). Conclusion The application of intravitreal injection of triamcinolone acetonide in patientswith cataracts and severe vitreous hemorrhage before phacoemulsification combined with PPV surgery is beneficial forimproving the surgical efficacy, which is worthy of clinical promotion.
      【Key words】 Cataract; Severe vitreous hemorrhage; Triamcinolone acetonide; Phacoemulsification; Pars planavitrectomy