超声乳化白内障吸除术后乙酰唑胺和阿可乐宁控制眼内压效果的比较_医学论文.docVIP

超声乳化白内障吸除术后乙酰唑胺和阿可乐宁控制眼内压效果的比较_医学论文 超声乳化白内障吸除术后乙酰唑胺和阿可乐宁控制眼内压效果的比较_医学论文 【摘要】 目的 比较全身应用乙酰唑胺和局部应用0.5%阿可乐宁控制老年性超声乳化白内障吸除术（超乳术）后控制眼内压的效果。方法 选择36例受试者36眼，随机选择12眼局部应用0.5%阿可乐宁行术后治疗，12例（12眼）口服乙酰唑胺，其余12眼不给予降压药药物治疗（对照组）。统计资料主要采用方差分析。结果 阿可乐宁组手术后24 h的眼内压明显低于对照组（P＜0.01）。结论 该项前瞻性研究表明，阿可乐宁可有效的预防超乳术后眼内压的升高。采用阿可乐宁的病人其眼内压低于乙酰唑胺组和对照组病人。考虑到局部应用危险性较小，因此认为超乳术后最好采用0.5%的阿可乐宁，而不采用口服乙酰唑胺。 【关键词】 阿可乐宁；乙酰唑胺；超声乳化白内障吸除术；眼内压 【Abstract】 Objective To compare the effects of systemically administered acetazolamide and topical apraclonidine 0.5% in the control of intraocular pressure (IOP) following phacoemulsification of senile cataracts.Methods Thirtysix eyes in 36 patients were selected.Twelve eyes randomly assigned to postoperative treatment with topical apraclonidine 0.5%,12 received oral acetazolamide and the remaining 12 received no hypotensive treatment (control group).Statistical analyses were performed mainly by means of analysis of variance.Results IOPs measured 24 h after surgery were significantly lower (P＜0.01）in the apraclonidine group compared to the control group.Conclusions Our prospective study shows that apraclonidine is effective in the prevention of IOP increases following phacoemulsification of senile cataracts.IOPs in patients with apraclonidine were lower than those in the acetazolamide and control group.Considering the lower risk of toxicity associated with topical administration,topical apraclonidine 0.5% seems to be preferable to oral acetazolamide in this postoperative setting. 【Key words】 apraclonidine,acetazolamide,phacoemulsification,intraocular pressure 白内障手术后早期眼内压升高的情况不少见［１，2］。其升高可起因于炎症，也可起因于粘弹性物质滞留导致的房水引流受阻［3，4］。为此，手术结束时必须仔细冲洗前房。手术后眼压的短暂升高有可能对视力造成影响，特别是视神经或血管床已经受损的病人。 用来控制手术后眼压升高的药物有多种。碳酸酐酶抑制剂乙酰唑胺和相对选择性的α2受体激动剂阿可乐宁（0.5%）起效迅速，因此尤其适合于白内障手术后的短期处理。两者都通过抑制房水的生成（不管是正常眼还是青光眼）而降低眼内压［5，6］。该研究的目的是比较着两种药物在控制老年性白内障超乳术后眼内压的效果。 1 资料与方法 1.1 临床资料 该研究收集了老年性白内障进行超乳术的36例病人36眼。所有病人都没有眼的其他病理情况［包括眼压（＞22 mm Hg）、原发性或继发性青光眼或高度近视］以及眼手术史。 1.2 方法 病人年龄52～80岁，平均（66±5.1）岁。所有病人的手术由同一名