背景:白内障手术对角膜内皮细胞构成风险。本研究旨在评估rho相关激酶抑制剂滴眼液(ricasudil)对白内障手术12个月后角膜内皮细胞的保护作用。
方法:我们进行了前瞻性,非随机化,非盲对照研究包括43例患者,分为两组:利帕舒地尔组(22例,23只眼)和对照组(21例,21只眼睛)。所有患者均为3级核性白内障,并接受了顺利的超声乳化人工晶状体植入术。在里帕苏地尔集团,每天三次给药1滴盐酸利帕舒地尔水合物(Glanatec®眼用溶液0.4%),共5天。结果测量包括中央角膜厚度(CCT)和内皮细胞密度(ECD),术前和术后12个月进行评估。
结果:在利帕舒地尔组,基线时的ECD中位数为2398(四分位距[IQR]410,2201-2611)个细胞/mm2,术后12个月时为2262(IQR298,2195-2493)个细胞/mm2.在对照组中,基线时的ECD中位数为2503(IQR390,2340-2730)个细胞/mm2,术后12个月时为2170(IQR324,2049-2373)个细胞/mm2.对照组内皮细胞丢失(ECL)为12.8%,利帕舒地尔组显著降低至4.5%(p=0.001*)。CCT(p=0.042),年龄(p=0.383),性别(p=0.944),和手术时间(p=0.319)不是显著的因素。两组均未观察到不良反应。
结论:在术后管理中加入瑞帕舒地尔有助于维持角膜内皮细胞的完整性,减少白内障手术后的细胞损失。可能减少眼内手术患者对内皮移植的需求。
BACKGROUND: Cataract surgery poses a risk to corneal endothelial cells. This study aimed to assess the protective effect of rho-associated kinase inhibitor eye drop (ripasudil) on corneal endothelial cells after cataract surgery over 12 months.
METHODS: We conducted a prospective, non-randomized, non-blinded comparative study including 43 patients divided into two groups: the ripasudil group (22 patients, 23 eyes) and the control group (21 patients, 21 eyes). All patients had grade 3 nuclear cataract and underwent uneventful phacoemulsification with intraocular lens implantation. In the ripasudil group, one drop of ripasudil hydrochloride hydrate (Glanatec® ophthalmic solution 0.4%) was administered three times a day for 5 days. Outcome measures included central corneal thickness (CCT) and endothelial cell density (ECD), which were evaluated preoperatively and 12 months postoperatively.
RESULTS: In the ripasudil group, the median ECD was 2398 (interquartile range [IQR] 410, 2201-2611) cells/mm2 at baseline and 2262 (IQR 298, 2195-2493) cells/mm2 at 12 months postoperatively. In the control group, the median ECD was 2503 (IQR 390, 2340-2730) cells/mm2 at baseline and 2170 (IQR 324, 2049-2373) cells/mm2 at 12 months postoperatively. Endothelial cell loss (ECL) was 12.8% in the control group, significantly reduced to 4.5% in the ripasudil group (p = 0.001*). CCT (p = 0.042), age (p = 0.383), sex (p = 0.944), and duration of surgery (p = 0.319) were not significant factors. No adverse effects were observed in either of the groups.
CONCLUSIONS: Incorporating ripasudil into postoperative management could help maintain corneal endothelial cell integrity and reduce cell loss after cataract surgery, potentially decreasing the need for endothelial transplantation in patients who have undergone intraocular surgeries.