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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。
OBJECTIVE: The use of triamcinolone acetonide (TA) suspension with anti-proliferative, anti-edema, anti-inflammatory and vascular stabilization effects in ocular edema, neovascularization and proliferative diseases, especially macular degeneration, is continually increasing. This article describes the formulation of TA for intravitreal injection and analyzes the actual dose after excipient (benzyl ethanol) filtration. Method: From a 40 mg VononA flask, equivalent to 40 mg of Kenalog, a 0.625 mL crystalline suspension was drawn, equivalent to TA25 mg. Under aseptic conditions, the suspension was filtered to remove the solvent, benzyl ethanol, and the crystals were washed 4 times with 9 g / L sodium chloride for TA vitreous injection. Close follow-up is required to monitor endophthalmitis within the first 2 weeks and ocular hypertension for 1 to 2 months. Results: The concentration of 25 mg TA is expected to be 23.8 mg after solvent filtration. In another pharmacy, the same result after filtration was 12.8 mg, none of the expected dose of 25 mg TA. Conclusion: There is no standard dose of intravitreal injection of TA. The surgeon should know that the filtered intravitreal dose of TA will be less than expected. Close follow-up after injection is required: Aseptic endophthalmitis or pseudo-endophthalmitis is monitored at 1wk and infectious endophthalmitis is identified at 2wk, which may appear in painless and non-bloody eyes but must be immediately treatment. Secondary ocular hypertension may occur 1 ~ 2mo after injection; generally available anti-glaucoma drug control.