| Ojectives:To study the effects of pranoprofen eye drops on pupil size and central macular thickness(CMT)before and after phacoemulsification in diabetic patients.Meanwhile,detect the concentration of prostaglandin E2(PGE2)in aqueous humor and explore the relationship between PGE2 concentration and the change of intraoperative pupil area.Methods:46 diabetic patients(46 eyes)who underwent phacoemulsification combined with intraocular lens(IOL)implantation in the second affiliated hospital of kunming medical university were selected from February 2018 to September 2018,and randomly divided them into control group including 25 patients(25 eyes)and experimental group including 21 patients(21 eyes).Control group:levofloxacin eye drops were given 3 days to prevent infection before surgery;after operation,tobramycin dexamethasone eye drops was given to anti-inflammatory for lmonth.Experimental group:On the basis of the drugs in the control group,the eye drops of pranoprofen was added to the patient from preoperative 3day to postoperative 1 month.The pupil images of two groups at the beginning and the end of the surgery were takers and calculated of the pupil area at two time points with Image J software.Meanwhile,100?l aqueous humor was extracted at the beginning of the operation,and the concentration of PGE2 of the aqueous humor was detected by enzyme-linked immuno sorbent assay(ELISA).The preoperative pupil area?changes of pupil area in intraoperative and prostaglandin E2(PGE2)concentration in aqueous humor were compared between two groups;and to analyze whether there is correlation between the change of pupil area and PGE2 concentration in the aqueous humor.Postoperative follow-up was conducted for 3month,and the CMT of preoperative 3day and postoperative 1 week,1month and 3month were measured by optical coherence tomography(OCT).The CMT of postoperative 1week,1month and 3month and the incidence of postoperative macular edema(ME)were compared between two groups.Results:Preoperative general clinical data of two groups were not statistically different,and there was comparability between two groups.(1)BCDVA(best corrected distant visual acuity):BCDVA of two groups before surgery was between 0.1 and 0.4,and the difference was not statistically significant(P>0.05).The BCDVA of two groups after operation was higher than before,and the difference was statistically significant(P<0.05).The BCDVA of the experimental group at lweek,1month and 3month after surgery was higher than that of the control group,but the difference was not statistically significant(P>0.05).(2)Pupil area and PGE2 concentration:the preoperative pupil area of the experimental group(58.48±5.52mm2)was larger than that of the control group(54.13±6.74mm2),the difference was statistically significant(P<0.05).Postoperative pupil area decreased in both,(54.05 ± 5.69mm2)in the experimental group and(45.76±7.95mm2)in the control group.Pupil area reduction in the experimental group(4.42±2.35mm2)was lower than that in the control group(8.36±3.99mm2),and the difference was statistically significant(P<0.05).PGE2 concentration in aqueous humor of the experimental group(200.85±9.18pg/ml)was lower than that of the control group(210.68±6.92pg/ml),and the difference was statistically significant(P<0.05).There was no correlation between the decrease of pupil area and PGE2 concentration in aqueous humor in both group(P>0.05).(3)CMT and ME:There was no significant changes of CMT between the preoperative of experimental group(240.65±10.72?m)and the control group(243.58±9.86?m)(P>0.05).At 1week after surgery,the CMT of experimental group was(254.10±11.42?m),and the that of control group was(262.08±8.69?m),the difference was statistically significant(P<0.05).At 1month in the experimental group was(273.85±18.23?m)and in the control group was(287.46±14.80?m)with statistically significant differences(P<0.05).The incidence of ME in the experimental group was 10%and that in the control group was 16.7%,with no statistically significant differences(P>0.05).Postoperative 3month was(263.70±23.24?m)in the experimental group and(271.08±17.18?m)in the control group,and the difference was not statistically significant(P<0.05).The incidence of ME was 10%in the experimental group and 14.3%in the control group,and the difference was not statistically significant(P>0.05).Conclusions:It is recommended that pranoprofen eye drops should be applied to cataract patients with diabetes during perioperative period.On the one hand,it can achieve better pupil dilation effect,and inhibit intraoperative miosis and maintain mydriasis.On the other hand,it also can reduce the increase of CMT value,which may inhibit the incidence of postoperative ME.There is no correlation between the reduction of intraoperative pupil area and PGE2 concentration in the aqueous humor for diabetic patients,which may be due to other inflammatory factors in the aqueous humor.Or PGE2 may cause intraoperative miosis,but it may not be the main factor,and it may work together with other inflammatory factors to cause intraoperative miosis. |
PDF Full Text Request