超声乳化能量、时间与眼压的关系及辅助切口放液治疗术后高眼压的临床研究  

The clinical study about relationship of phaco power, ultrasound time and intraocular pressure and treatment of decreasing intraocular pressure via tapping from adjunctive incision

作　　者：翟洪[1] 赵鲁新[1] 王哲[1] 张焱 张劲松[3] 

机构地区：[1]山东省淄博市中心医院眼科,255036 [2]淄博市第三人民医院 [3]中国医科大学附属第一医院眼科

出　　处：《临床眼科杂志》2005年第6期487-490,共4页Journal of Clinical Ophthalmology

摘　　要：目的探讨白内障超声乳化吸除术中超声能量、时间与术后早期眼压升高的关系,评价角膜缘辅助切口放液治疗术后早期高眼压的效果。方法年龄相关性白内障患者101例(144只眼)随机分为软性人工晶状体(intraocular lens,IOL)植入组(简称软性IOL)和硬性人工晶状体植入组(简称硬性IOL组),又根据术后处理高眼压的方法不同分为辅助切口放液组(36只眼)和药物治疗组(36只眼),用Goldmann压平式眼压计测量术前、术后4～6h、术后24h各组眼压值。记录术中平均超声能量和超声时间,计算有效超声时间(effective phaco time,EPT)和眼压升高的百分数,用Spearman等级相关估计眼压升高的百分率和EPT的关系。辅助切口放液组为结膜囊内滴表面麻醉剂后在裂隙灯显微镜下用一次性针头轻压角膜缘辅助切口后唇放出部分房水,比较与药物治疗组控制眼压的效果。结果软性IOL眼压升高与EPT分别是(55.11±74.17)％和(6.61±3.71)s,Spearman等级相关系数为0.636,P＜0.05；硬性IOL则是(42.32±68.92)％和(4.61±3.10)s,Spearman等级相关系数为0.508,P＜0.05。辅助切口放液组24h内眼压全部控制在正常,药物组需要3～4天完全控制眼压。结论白内障超声乳化吸除术中超声能量、时间与术后早期眼压升高具有相关性,角膜缘辅助切口放液治疗术后高眼压简单、安全、有效。Objective To investigate the relationship of phaco power,ultrasound time and immediate intraocular pressure（IOP） rise in pbeceemulsification. To evaluate the effect of decreasing IOP after surgery via adjunctive limbus corneae incision. Methods This randomized study comprised 101 patients（ 144 eyes） with age - related cataract. The patients were divided into 2 groups ：soft intraocular lens（IOL） group（ soft IOL） and durus IOL. The 2 groups were divided into adjunctive limbus corneae incision tapping（36 eyes） and drug treatment（36 eyes）. The IOP was measured preoperatively and postoperatively 4 - 6h and 24h after sngery with a Goldmann applanation tonometer. The intraoperative mean phaco power and ultrasound （US） time were noted. The effective phaco time （EFT） and percentage of IOP rise were ealculated. The correlation between the EFT and percentage of rise in IOP was evaluated using Spearman＇ s rank convlation. In adjunctive incision tapping group, polydocanol was dropped into conjunctival sac, the posterior lip of adjunctive limbus comeae incision was pressed lightly to release some aqueous fluid with a disposable pinhead. To compare the change of IOP in 2 groups. Results The mean rise in IOP was（ 55.11 ±74.17）% inthesoft IOL group and （42.32±68.92）% inthedurus IOL group, the mean EFT,6.61 ± 3.71 seconds and 4.61 ± 3.10 seconds, respectively and the spearman＇ s correlation coefficient was 0. 636 （ P 〈 0.05） and 0.508 （ P 〈 0.05）. All pressures were normal in adjunctive incision tapping group in 24h and drug treatment group in 3 ～ 4d. Conclusion The rise in early IOP was correlated with the phaen energy and ultrasound time in phacoemulsification. Tapping from adjunctive limbns comeae incision was simple, safe and effective to decrease IOP after surgery.

关 键 词：超声乳化白内障吸除术 眼压 晶状体 人工 

分 类 号：R775[医药卫生—眼科] R779.66[医药卫生—临床医学]