环氧化酶抑制剂在不同给药时机预防糖尿病患者白内障术后黄斑水肿的研究
The Study of Cyclooxygenase Inhibitors in the Prevention of Macular Edema after Cataract Surgery in Diabetic Patients at Different Administration Time

目的：探讨环氧化酶抑制剂在不同给药时机对糖尿病患者白内障超声乳化术后黄斑水肿的预防作用。方法：选择2015年1月至2017年12月在我院行白内障超声乳化吸除联合人工晶状体植入术的II型糖尿病白内障患者90例90眼，随机分入三组：对照组30例，术后1d开始滴用妥布霉素地塞米松眼液，4次/d用药2周；术后用药组30例，在对照组用药的基础上术后1d开始滴用普拉洛芬滴眼液，4次/d用药1月；术前用药组30例，在对照组用药的基础上术前3d开始滴用普拉洛芬滴眼液，4次/d用药至术后1月。分别于术前、术后1周、1月行眼部常规检查(包括BCVA、眼压、裂隙灯检查、眼底镜检查)及OCT检查。结果：对照组、术后用药组、术前用药组三组患者术后BCVA均有所提高，但术后1月三组患者的BCVA差异有统计学意义(P < 0.05)；术后1月三组患者黄斑中心凹厚度差异有统计学意义(P < 0.05)。结论：糖尿病患者在行白内障超声乳化术前应用环氧化酶抑制剂(普拉洛芬滴眼液)能有效预防黄斑水肿的发生。
Objective: To explore the preventive effect of cyclooxygenase inhibitors on macular edema after phacoemulsification in diabetic patients at different administration time. Methods: From January 2015 to December 2017, 90 eyes of type 2 diabetic cataract patients who underwent phacoemulsification combined with intraocular lens implantation in our hospital were selected and randomly divided into three groups: 30 cases in the control group were treated with tobramycin and dexamethasone eye drops 1 day after operation, 4 times a day for 2 weeks; 30 patients in the postoperative medication group, on the basis of the control group, were treated with pranoprofen eye drops 1 day after the operation, 4 times a day for 1 month; 30 patients in the preoperative medication group, on the basis of the medication in the control group, were treated with pranoprofen eye drops 3 days before the operation, and the medication was administered 4 times per day until 1 month after the operation. Routine eye examinations (including BCVA, intraocular pressure, slit lamp examination, and fundoscopy) and OCT examination were performed before surgery, 1 week and 1 month after surgery. Results: The BCVA of the three groups of the control group, the postoperative medication group and the preoperative medication group all improved after surgery, but the difference in BCVA of the three groups was statistically significant (P < 0.05); the difference in the thickness of the fovea of the three groups was statistically significant at the first month after surgery (P < 0.05). Conclusion: The application of cyclooxygenase inhibitors (pranoprofen eye drops) in diabetic patients before phacoemulsification can effectively prevent the occurrence of macular edema.