目的:比较非甾体类抗炎药在不同的给药时机对白内障术后黄斑中心凹厚度的影响,以及糖尿病患者与单纯性白内障患者在给药时机上是否存在差异。方法:将于我院施行白内障超声乳化吸除联合后房型人工晶状体植入手术的患者90例90眼纳入试验,其中糖尿病患者46例46眼,单纯性白内障患者44例44眼,所有患者随机分入试验组与对照组,每组45例含有23例糖尿病患者和22例单纯性白内障患者,试验组:术前1d开始应用普拉洛芬滴眼液,术后第1d继续应用普拉洛芬滴眼液至术后30d;对照组:术后第1d开始应用普拉洛芬滴眼液至术后30d,两组患者均于术后第1d开始应用地塞米松/妥布霉素滴眼液,所有滴眼液点眼4次/d。分别在术前7d内,术后第7d和术后第30d采用光学相干断层扫描仪定量测定黄斑中心凹厚度。结果:试验组与对照组的黄斑中心凹厚度在术后第7d无显著性差异(P>0.05),在术后第30d有显著性差异(P<0.05)。试验组与对照组中糖尿病患者的黄斑中心凹厚度及黄斑中心凹厚度增加值在术后第7d及第30d均有显著性差异(P<0.05);试验组与对照组中单纯性白内障患者的黄斑中心凹厚度和黄斑中心凹厚度增加值在术后第7d及术后第30d均无显著性差异(P>0.05)。结论:糖尿病患者在白内障术前应用非甾体抗炎药滴眼液比术后应用可显著降低术后黄斑中心凹视网膜增厚的程度。我们的研究结果提示,当治疗糖尿病患者的白内障时,建议在术前开始应用非甾体抗炎药滴眼液,以减轻术后黄斑中心凹厚度增加,从而有助于降低糖尿病患者白内障术后发生黄斑水肿的风险。

AIM:To compare the effects of non-steroidal anti-inflammatory drugs（NSAIDs） at different administration timing on central foveal thickness following cataract surgery in patients with cataracts and cataracts with diabetes. METHODS:Ninety patients were divided into two groups randomly in this prospective,randomized study. Each group had 23 patients with cataracts and diabetes and 22 patients with cataracts only.These groups were enrolled for cataract surgery from Feb.2009 to Sep.2009 without any postoperative complications.In groupⅠ（trial group）,pranoprofen was administered one day before surgery in 45 eyes.In groupⅠ（control group）, pranoprofen was administrated one day following cataract surgery in 45 eyes.All patients were treated with topical tobramycin and dexamethasone one day after surgery. Central foveal thickness was measured via pptical coherence tomography（OCT） during the final week before surgery as well as on the 7^th day and 30^th day after surgery. RESULTS:No significant differences were found in central foveal thickness between the groups on the 7^th day after surgery,however,there were significant differences in central foveal thickness between groups on the 30 day after surgery.There were no significant differences in central foveal as well as retinal thickening of the macular fovea in patients purely with cataracts on the 7^th and 30^th postoperative day.In the patients with cataracts and diabetic disease,significant differences were found in central foveal thickness and retinal thickening of macular fovea compared to patients with only cataracts（P<0.05） on the 7^th and 30^th day after surgery. CONCLUSION:Pranoprofen administrated preoperatively has better effects on alleviating retinal thickening of fovea centralis compared to its postoperative administration in the patients with cataracts and diabetic disease.Our findings suggest that preoperative administration of pranoprofen should be taken into account when we treat cataract patients with diabetic disease.

R774.5