穿透性角膜移植术后高眼压的临床分析  

Clinical analysis of high intraocular pressure after penetrating keratoplasty

作　　者：王艳青[1] 王新[1] 刘平[1] 

机构地区：[1]郑州人民医院眼科,河南省郑州市450003

出　　处：《眼科新进展》2013年第12期1181-1183,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨穿透性角膜移植术(penetrating keratoplasty,PKP)后眼压升高的临床特征。方法对160例(168眼)PKP术后患者的临床资料进行回顾性分析,术后50例(50眼)出现眼压升高,其中一过性眼压升高19眼,继发性青光眼31眼,根据不同原因分别进行药物或(和)手术治疗,分析其病因、影响因素,同时观察术后眼压升高的时间。结果术后早期继发性青光眼的发生时间主要集中在术后1周内,其中最早出现在术后3 h;术后晚期继发性青光眼出现在术后3周~9个月,多数在术后4个月内。引起继发性青光眼的危险因素包括细菌、真菌、病毒性角膜溃疡穿孔、角膜瘘,真菌性角膜溃疡等。存在眼部既往病变患者与未存在既往病变患者术后继发性青光眼发生率分别为7.69%、25.24%(26/103),差异有统计学意义(χ2=8.17,P<0.05)。结论 PKP术后眼压升高与术前角膜疾病有关,主要危险因素为术前角膜穿孔、真菌性角膜溃疡等。Objective To investigate the clinical characteristics of high intraocular pressure(IOP)after penetrating keratoplasty(PKP).Methods The clinical data of 160 patients(168 eyes)after PKP were retrospectively analyzed,in which 50 cases(50 eyes)had high IOP,including transient high IOP in 19 eyes,secondary glaucoma in 31 eyes,according to different causes the drug treatment or surgery were performed,the etiological factor was analyzed,and the appeared time of postoperative high IOP was observed.Results The early postoperative secondary glaucoma mainly appeared within 1 week after operation,in which the earliest appeared at 3 hours after operation;The later postoperative secondary glaucoma mainly appeared from 3 weeks to 9 months after operation,almostly within 4 months after operation. The etiological factor of secondary glaucoma included bacterial,fungal or viral corneal ulcer and fistula,et al.The incidence rate of secondary glaucoma in patients with or without previous ocular diseases were 7.69%and 25.24%,respectively,there was statistical difference(X^2=8.17, P<0.05).Conclusion The high IOP after PKP is related with the preoperative corneal diseases,the main risk factors are preoperative corneal perforation,fungal corneal ulcer,et al.

关 键 词：穿透性角膜移植术 高眼压 继发性青光眼 

分 类 号：R779.65[医药卫生—眼科]