球后注射曲安奈德联合激光光凝治疗白内障术后慢性黄斑囊样水肿.docVIP

球后注射曲安奈德联合激光光凝治疗白内障术后慢性黄斑囊样水肿 作者：秦燕,徐明,陶建军,王瑾瑜 【摘要】 　　目的:观察比较激光治疗与激光联合球后注射曲安奈德(triamcinolone acetonide, TA)治疗白内障术后慢性黄斑囊样水肿的临床疗效。方法:对37例37眼白内障术后发生慢性黄斑囊样水肿的患者17眼,球后注射曲安奈德联合激光光凝,20眼单纯光凝治疗,随访6mo,对比分析两组治疗前后视力、眼底荧光素血管造影的变化及并发症。结果:所有患者治疗1mo后视力多数有明显提高。治疗6mo后，联合治疗组视力提高gt;2行者11眼(65%),视力稳定及变化在1行之内者4眼(23%),视力下降gt;2行者2眼(12%)；水肿减轻 14眼（82%）,水肿未退 3眼(18%);单纯光凝组视力提高gt;2行者3眼(15%),视力稳定及变化在1行之内者11眼(55%),视力下降gt;2行者6眼(30%)。水肿减轻9眼（40%）,水肿未退11眼(60%)。两组比较差异有统计学意义(Plt;0.05)。结论：激光联合球后注射曲安奈德较单纯激光治疗白内障术后黄斑囊样水肿疗效更好,且安全、方便。 【关键词】 白内障；黄斑囊样水肿；曲安奈德；光凝 　　Abstract　AIM: To investigate the effect of retrobulbar injection of triamcinolone acetonide(TA) combined with laser photocoagulation for chronic cystoid macular edema after cataract operation. METHODS: Thirtyseven patients 37 eyes with chronic cystoid macular edema after cataract operation were included. Seventeen eyes were treated with retrobulbar injection of TA combined with laser photocoagulation and twenty eyes only received laser photocoagulation. The followup time was 6 months. Visual acuity, fundus fluorescein angiography(FFA) and complications were observed and compared after treatment. RESULTS: All eyes had improved visual acuity after one month. At the end of the followup of 6 months, among the patients with retrobulbar injection of TA combined with laser photocoagulation, visual acuity was improved by 2 lines or more in 11 eyes (65%), improved within 1line or remained the same in 4 eyes (23%), decreased in 2 eyes (12%). Edema in 14 eyes (82%) was relieved after treatment. Among patients with laser photocoagulation, visual acuity was improved by 2 lines or more in 3 eyes (15%), improved within 1line or remained the same in 11 eyes (55%), edema in 9 eyes (40%) was relieved after treatment. The difference between the two groups was statistically significant (Plt;0.05). CONCLUSION: Retrobulbar injection of TA combined with laser photocoagulation for chronic cystoid macular edema after cataract operation is