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首页> 美国卫生研究院文献>The British Journal of Ophthalmology >Effectiveness of apraclonidine 1 in preventing intraocular pressure rise following macular hole surgery
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Effectiveness of apraclonidine 1 in preventing intraocular pressure rise following macular hole surgery

机译：1％apraclonidine预防黄斑裂孔术后眼内压升高的有效性

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AIM—To determine the efficacy of apraclonidine hydrochloride 1% in preventing intraocular pressure (IOP) spikes following idiopathic macular hole (IMH) surgery with platelet adjunct and intraocular gas tamponade.
METHODS—This is a prospective, double masked, randomised study to compare apraclonidine hydrochloride 1%, an α2 agonist, with a placebo in the prevention of IOP rises following macular hole surgery. Each patient was randomly selected to receive either the study drug or the placebo; one drop was instilled in the conjunctival sac 2 hours preoperatively and on completion of the procedure. IOP was measured at baseline and at 1, 3, 6, 24, 48 hours, and 2 weeks postoperatively. Blood pressure and heart rate were also recorded at baseline and at 3 and 24 hours postoperatively. Macular hole repair surgery was performed as standardised in the unit with a vitrectomy, platelet concentrate, and complete fill of the vitreous cavity with perfluoropropane gas (C3F8) at a concentration of 16%.
RESULTS—25 patients (26 eyes) were enrolled. 12 eyes received apraclonidine hydrochloride 1% (mean age 70.7; range 62-78 years) and 14 eyes received the placebo (mean age 70.0; range 57-81 years). At baseline evaluation the mean IOP was 15.6 mm Hg for the study group and 14.3 mm Hg for the placebo group. The mean postoperative IOP at 1 hour, 3 hours, 6 hours, and 24 hours was 10.6, 9.6, 8.2, and 14.0 mm Hg in the apraclonidine group. In the control group at the same time intervals the mean IOP was 23.4, 17.5, 19.2, and 24.7 mm Hg. These readings were statistically significant different: 1 hour (p=0.0001); 3 hours (p=0.0015); 6 hours (p<0.0001); and 24 hours (p=0.019), the readings at 48 hours and 2 weeks were not statistically significant different (p=0.15 and p=0.59). Only one of the patients in the study group had an IOP above 25 mm Hg at any time. In the control group an IOP above 25 mm Hg was found in seven patients (50%) at the 1 hour postoperative measurement. At 2 weeks the IOP was recorded below 25 mm Hg in all patients. No statistically significantly difference was noted between the two groups regarding the systolic or diastolic blood pressure values and the heart rate records. No local or systemic adverse reactions were observed.
CONCLUSIONS—Apraclonidine hydrochloride 1% appears to be an efficacious and safe drug in the prophylaxis of early postoperative IOP elevations in patients undergoing macular hole surgery.
机译：目的：确定1％盐酸阿普拉卡尼定在预防特发性黄斑裂孔（IMH）并发血小板和眼内气体压塞后的眼内压（IOP）增高的疗效。
方法-这是一种前瞻性，双重屏蔽，随机分组的方法一项研究比较了1％α2激动剂盐酸apraclonidine和安慰剂在预防黄斑裂孔术后IOP升高方面的作用。随机选择每位患者接受研究药物或安慰剂。术前2小时并在手术完成后将1滴滴入结膜囊中。术后1、3、6、24、48小时和2周测量基线眼压。在基线以及术后3和24小时还记录了血压和心率。黄斑裂孔修复手术在玻璃体切除术，血小板浓缩液和玻璃体腔中以16％的全氟丙烷气体（C3F8）完全填充的标准方式进行。
结果— 25例患者（26眼）被录取了。 12眼接受1％盐酸阿普拉克隆定（平均年龄70.7;范围62-78岁），14眼接受安慰剂（平均年龄70.0;范围57-81岁）。在基线评估中，研究组的平均IOP为15.6 mm Hg，安慰剂组的平均IOP为14.3 mm Hg。阿普拉可乐定组术后1小时，3小时，6小时和24小时的平均IOP为10.6、9.6、8.2， 和14.0 mm Hg。在相同时间间隔的对照组中，平均IOP为23.4、17.5、19.2， 和24.7 mm Hg。这些读数在统计上有显着差异：1小时（p = 0.0001）； 3小时（p = 0.0015）; 6小时（p <0.0001）;与24小时（p = 0.019）相比，在48小时和2周时的读数无统计学差异（p = 0.15和p = 0.59）。在任何时候，研究组中只有一名患者的眼压高于25毫米汞柱。对照组在术后1小时测量时发现7名患者（50％）的IOP高于25 mm Hg。所有患者在2周时的IOP均低于25毫米汞柱。两组之间在收缩压或舒张压值和心率记录上没有统计学上的显着差异。没有观察到局部或全身不良反应。
结论— 1％盐酸阿普拉可尼定是预防黄斑裂孔术后早期IOP升高的有效且安全的药物。

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