摘要
目的:具有抗增生、抗水肿、抗炎和血管稳定作用的曲安奈得(TA)混悬液在眼水肿、新生血管和增生性疾病,特别是黄斑疾病的应用正在不断增加。本文描述玻璃体内注射用的TA的配制法并分析赋形剂(苯甲基乙醇)过滤后的实际剂量。方法:从40mgVolonA瓶中,相当于Kenalog40mg,抽取0.625mL结晶混悬液,相当于TA25mg。在无菌条件下,过滤混悬液以去除溶剂苯甲基乙醇,结晶体用9g/L氯化钠洗涤4次,进行TA玻璃体注射。需要密切随访,监测在头2wk内的眼内炎和1￣2mo的高眼压。结果:预期25mgTA的浓度在溶剂过滤后测量为23.8mg。在另一个药学实验室,同样过滤后结果是12.8mg,均不是预期的剂量25mgTA。结论:还没有玻璃体内注射TA的标准剂量。手术医生应该知道过滤后玻璃体内注射TA的剂量将比预期的要少。需要在注射后密切随访:在第1wk监测无菌性眼内炎或假性眼内炎,在第2wk要识别感染性眼内炎,它可能出现在无痛和不充血的眼,但必须立即治疗。继发性高眼压可能在注射后1￣2mo发生;一般可用抗青光眼药物控制。
AIM： Background. Triamcinolone acetonide （TA） suspension with anti-proliferative, anti-edematous, anti-intlammatory and angiostatic effects is increasingly being used for ocular edematous, neovascular and proliferative diseases, in particular of the macula. Preparation of TA for intravitreal injection will be described and its actual dosage after filtration of the vehicle （benzyl alcohol） be analyzed. METHODS： From a bottle of 40 mg Volon A, analogue to Kenalog 40 mg, 0.625 mL of crystal suspension are withdrawn which would equal 25 mg TA. Under sterile conditions the suspension is filtered to remove the solvent benzy! alcohol, the crystals 4 times washed with NaCl 9g/L and the intravitreal TA injection done. Close follow-up is needed to detect endophthalmitis within the first 2wk and ocular hypertension after 1 to 2mo. RESULTS： The concentration of an intended dosage of 25mg TA measured after filtration of the solvent at 23.8mL. The same regimen for filtration, applied at another pharmacy department, resulted in 12.8mg, instead of the intended dosage of 25mg TA. CONCLUSION： Standardized dosages of TA for intravitreal injection are not available. The surgeon should be aware that the dosage of intravitreal TA after filtration will be less than intended. Close follow-up after injection is needed： During the first week to detect a sterile endophthalmitis or pseudo-endophthalmitis, during the second week to recognize an infectious endophthalmitis, which might be present in a painless and white eye, but which has to be treated immediately, Secondary ocular hypertension might develop 1 to 2mo after injection; in general controlled by antiglaucomatous medication.
出处
《国际眼科杂志》
CAS
2005年第5期881-883,共3页
International Eye Science
