摘要
目的 探讨玻璃体切割手术 (pars plana vitrectomy,PPV)后发生高眼压的危险因素。 方法 对 339例 PPV患者 343只手术眼中 88只手术后非接触式眼压计测量眼压在 2 5 mm Hg(1mm Hg=0 .133k Pa)及其以上的患眼临床资料进行回顾性分析 ,着重分析高眼压发生、持续时间 ,与原发病及眼内手术史、手术方式的关系。 结果 77只眼高眼压发生在手术后 1～ 2周内 ,占 87.5 %。88只高眼压眼经过治疗 6 5只眼眼压在 1周内恢复正常 ;14只眼在 1个月内恢复正常 ;6只眼药物控制下眼压维持在 2 5～30 m m Hg以下 ;3只眼高眼压持续时间超过 4～ 6个月 ,最终视功能丧失或接近丧失。手术后高眼压的发生率以视网膜脱离伴增生性玻璃体视网膜病变 C2 或以上组为最高 (38.2 % ,P<0 .0 5 ) ;有眼内手术史组较无眼内手术史组高 (P<0 .0 5 ) ;联合巩膜环扎、眼内注气、硅油注入、弥漫性光凝也与手术后眼压增高有关 (复相关系数 r=0 .82 9,P<0 .0 1)。 结论 PPV后高眼压的危险因素与眼内手术史、原发病的种类及严重程度、联合手术的种类与数量有关。
Objective To investigate the risk factors of the intraocular pressure (IOP) elevation after pars plana vitrectomy (PPV). Methods Eighty eight patients (88 eyes) of postoperative ocular hypertension in a series of 339 patients who had undergone PPV with normal ocular pressure before operation were retrospectively studied. The ocular pressures in both preoperative and postoperative periods were detected by NCT examination, and the ocular hypertension was decided on the level of ≥25 mm Hg. The relationships of occurence of the time of onset and duration of persistence of postoperative ocular hypertension with the different kinds of primary diseases, the techniques of operation, and the condition whether or not the affected eyes had formerly accepted surgical intervention, were analyzed. Results The IOP elevation occures mostly within 1 to 2 weeks postoperatively (77 eyes, 87.5%). In 65 cases (65 eyes) IOP returned to normal in 1 week, and in another 14 cases (14 eyes) in 1 month after treatments. Six patients' (6 eyes ) IOP was under 25 to 30 mm Hg with the medicine. With sustained elevation of IOP over 4 to 6 months, 3 cases (3 eyes ) lost or almost lost their vision finally. The probability of postoperative IOP elevation in the patients suffered from the retinal detachment with proliferative vitreoretinopathy (PVR) ≥grade C 2 was the highest in all the patients in our study (38.2%, P< 0.05). The patients who had intraocular surgery before were more likely to have IOP elevation than the ones without intraocular surgery ( P< 0.05). Placement of a scleral buckle, use of expansile gases or silicone oil injection and scatter endophotocoagulation intraoperatively were related to the postvitrectomy IOP elevation ( γ =0.829, P< 0 001). Conclusions The previous intraocular surgeries, certain primary eye diseases and combined ocular procedures are the risk factors of IOP elevation after PPV.
出处
《中华眼底病杂志》
CAS
CSCD
2002年第2期106-108,共3页
Chinese Journal of Ocular Fundus Diseases
关键词
眼高压
病因学
玻璃体切除术
手术后并发症
危险因素
Ocular hypertension/etiology
Vitrectomy/adverse effects
Postoperative complications
