目的：评估前房注射0.1% 莫西沙星联合结膜下注射4 mg曲安奈德预防白内障超声乳化术后感染和炎症的疗效，并与局部滴药组比较。

方法：共纳入1000例，平均年龄38～70岁，全部行超声乳化术的患者分为两组，两组在年龄、术前眼压(IOP)和中心黄斑厚度(CMT)方面无显著差异，分别为P=0.6， P=0.9 和P=0.8。对照组患者500例，术后1mo每日4次局部应用0.5%盐酸莫西沙星和0.1%地塞米松滴眼液。研究组在手术结束时，前房注入0.1%莫西沙星0.4 mL联合4 mg曲安奈德结膜下注射。随访时间为术后1d、1wk、1mo和3mo。检查4次前房反应，测量3次眼压，最后一次测量CMT。

结果：该临床试验研究中两组人群分别应用不同的预防方法，两组无眼内炎病例发生。通过两样本t检验，术后1d，研究组前房细胞显著低于对照组，而术后1wk、1mo和3mo两组间无统计学差异。在第3mo随访时，两组间眼压和中心黄斑厚度无明显差异。对照组炎症发生率为9.6%，研究组为4%。对照组在1mo时眼压升高≥10 mmHg患者占2.4%， 显著高于研究(0.8%)。

结论：白内障术后联合应用前房内莫西沙星和结膜下曲安奈德可有效预防感染和炎症，并且大多数(480例)患者不需其它任何外用药物， 这为患者节省了成本， 并帮助降低无法实施局部用药的病人并发症的几率与依从性差的患者术后不良药物反应。

AIM: To evaluate the effectivity of the combination of intracameral moxifloxacin 0.1% with subconjunctival triamcinolone acetonide 4 mg as prophylaxis of infection and inflammation after phacoemulsification in comparison with topical medication treated group.

METHODS: A total one thousand patients with age range from 38 to 70 years old who scheduled for phacoemulsification were divided into 2 groups of no statistically significant differences in age, preoperative intraocular pressure(IOP)and central macular thickness(CMT), P=0.6, 0.9 and 0.8 respectively. The surgeries were done by 2 surgeons each one planned to use one method of prophylaxis at Eye Speciality Private Hospital, Baghdad, Iraq. For the 1^st group of patients(500)a topical moxifloxacin hydrochloride 0.5% and dexamethasone 0.1% eye drops were prescribed four times a day for 1mo postoperatively. For the 2^nd group intracameral(IC)diluted moxifloxacin at 0.1% with subconjunctival(SC)triamcinolone 4 mg in 0.4mL were administered at the conclusion of the surgery. Follow up visits were on the first postoperative day, 1wk, 1mo, and 3mo postoperatively. Anterior chamber(AC)reaction was examined during the 4 visits while IOP was measured during the last 3 and CMT was measured only in the last one.

RESULTS: The current clinical trial study compared 2 samples with 2 different prophylaxis methods. No endophthalmitis case reported in both group. By a 2-Sample t-test, the IC-treated group(group 2)had statistically significant lower AC cells at the 1^st day postoperative visit than the other group while there were no statistically significant differences at 1wk, 1 mo and 3mo visits between the 2 groups. There was no statistically significant difference at 3mo visits in IOP and CMT between the two groups. A breakthrough inflammation rate with the topical medication was 9.6% while in the other group(IC treated )was 4.0%. A significant IOP elevation ≥10 mmHg at 1mo in 2.4% within the topical medication group which was higher than the rate in the other group(0.8%).

CONCLUSION: In addition to the safety and effectivity of the combination of intracameral moxifloxacin and subconjunctival triamcinolone in preventing infection and inflammation after cataract surgery. The majority(480)of our included patients didn't require any topical postoperative medication that is cost saving for the patient, helped patients who were unable to administer topical medication, and decreased chance of complication related to patient poor adherence to postoperative medication.