摘要：
Objective To evaluate the efficacy and safety of topical diclofenac sodium 0.1％ on femtosecond laser-assisted cataract surgery.Methods A prospective,randomised study.Ninety-six age-related cataract subjects (96 eyes) scheduled to undergo femtosecond laser-assisted cataract surgery were randomized into two groups according to the topical treatment:Group 1,study group (51 eyes),preoperative diclofenac sodium 0.1％ and levofloxacin 0.5％ postoperative add steroid;Group 2 (45 eyes),preoperative levofloxacin 0.5％ only,postoperative add steroid,as a control group.No epinephrine was used in the intraoperative irrigation solution.Outcome measures included intraoperative change in pupil size,postoperative change in macular thickness and volume.Pupil diameter was measured three different times during surgery:in frout of femtosecond laser,before the first incision formation and the end of phacoemulsification.Macular thickness was measured during the preoperative,i day,7 days and 1 month postoperatively.Results The study group had smaller intraoperative pupil diameter changes compared to the control group,the differences among two groups arrived significance statistically (P ＜0.05).No significant differences were found in central foveal thickness (CFS) between the groups on the preoperative,1 day,and 7 days after surgery (P ＞0.05),however,there were significant differences in CFS between the groups on the 1 month postoperatively (P ＜0.05).Conclusions Adding preoperative and postoperative diclofenac sodium 0.1％ to topical treatment can reduce intraoperative miosis and macular change more effectively than postoperative steroid alone.%目的 评估0.1％双氯芬酸钠在飞秒激光辅助的白内障超声乳化手术(femtosecond laser-assisted cataract surgery)中的有效性及安全性.方法 前瞻性随机对照病例研究.选取2014年6月至2015年5月在武汉爱尔眼科医院就诊的年龄相关性白内障患者共96例96只眼,行飞秒激光辅助的白内障超声乳化手术治疗,根据围手术期局部用药的种类分为两组:第一组为观察组(51只眼),术前局部使用0.1％双氯芬酸钠滴眼液及喹诺酮类药物,术后加用皮质类同醇类药物;第二组为对照组(45只眼),术前局部使用喹诺酮类药物,术后同样加用皮质类固醇类药物.手术灌注液中不添加肾上腺素.观察指标包括飞秒激光开始前、超声乳化切口穿通前及手术结束时的瞳孔直径,术前及术后1d、7d、1 m的黄斑中心凹厚度.结果 观察组术中瞳孔缩小的程度均小于对照组,且差异有统计学意义(P＜0.05).观察组与对照组的黄斑中心凹厚度在术前、术后1d及术后7d均差异无统计学意义(P＞0.05),在术后1个月差异有统计学意义(P＜0.05).结论 在飞秒激光辅助的白内障超声乳化手术中局部使用0.1％双氯芬酸钠能减轻术中瞳孔缩小的发生,同时有助于降低术后发生黄斑囊样水肿的风险.
