Effects of preoperative topical application of prednisolone acetate on intraoperative pain and inflammatory factors in aqueous humor in HBV carriers undergoing cataract surgery

Authors: Tian Shuai, Tang Tingting, Zhang Jingshang, Wan Xiuhua

Citation

Tian Shuai, Tang Tingting, Zhang Jingshang, et al. Effects of preoperative topical application of prednisolone acetate on intraoperative pain and inflammatory factors in aqueous humor in HBV carriers undergoing cataract surgery[J]. Chin J Exp Ophthalmol, 2024, 42(11): 1006-1011. DOI: 10.3760/cma.j.cn115989-20240215-00043.

ABSTRACT                [Download PDF] [Read Full Text]

Objective  To investigate the effects of 0.1% prednisolone acetate eye drops on the intraoperative pain and expression levels of inflammatory factors in hepatitis B virus (HBV) carriers undergoing cataract surgery.

Methods  A randomized single-blind controlled study was adopted.Thirty-six cataract patients diagnosed as HBV carriers in Beijing Tongren Hospital Affiliated to Capital Medical University from November 2021 to August 2023 were enrolled.All patients were scheduled to underwent phacoemulsification combined with intraocular lens implantation.The patients were randomly divided into prednisolone acetate group and control group using the random number table method, with 18 cases in each group.The two groups used 0.1% prednisolone acetate eye drops combined with 0.5% levofloxacin eye drops and 0.3% sodium hyaluronate eye drops combined with 0.5% levofloxacin eye drops for 3 days before the operation according to grouping, respectively.During cataract surgery, aqueous humor samples were collected, and cytokines in the samples were detected using the human cytokine antibody array detection technology.The degree of intraoperative pain of patients was evaluated using the Wong-Baker Scale and the intraoperative pain manifestation record form.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TREXKY2017-018).Written informed consent was obtained from each subject.

Results  In the aqueous humor samples of patients in the prednisolone acetate group, the expressions of inflammatory factors such as tumor necrosis factor-β, monocyte chemoattractant protein-1, tumor necrosis factor-α, and interleukin-1 receptor antagonist were lower than those in the control group, and the differences were statistically significant ( t=-2.385, -2.286, -2.208, -2.134; all at P<0.05).The proportion of patients with obvious pain in the prednisolone acetate group was 16.7%(1/18), which was significantly lower than 61.1%(11/18) in the control group ( χ 2=-2.697, P<0.05).The intraoperative pain score of patients in the prednisolone acetate group was 1(1, 2) points, which was lower than 2(1, 2) points in the control group, and the difference was statistically significant ( Z=-2.902, P<0.05).

Conclusions  Preoperative use of prednisolone acetate eye drops for anti-inflammatory intervention can reduce the expression of inflammatory factors in patients’ aqueous humor and mitigate the intraoperative pain during cataract surgery in HBV carriers.

Hepatitis B virus;Inflammatory factors;Cataracts;Prednisolone acetate;Pain

Authors Info & Affiliations 

Tian Shuai
Department of Ophthalmology, School of Clinical Medicine, Shandong Second Medical University, Weifang 261053, China
Tang Tingting
Department of Ophthalmology, School of Clinical Medicine, Shandong Second Medical University, Weifang 261053, China
Zhang Jingshang
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
Wan Xiuhua
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100005, China
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