准分子激光屈光性角膜手术后激素性高眼压药物干预后的眼压观察  

Long-term follow-up of IOP for corticosteroid-induced ocular hypertension after laser keratorefractive with short-term application of anti-glaucoma medications

作　　者：郑磊[1] 张建华[1] 高鹏[1] 王红英[1] 雷蕾[1] 王倩[1] 

机构地区：[1]第二军医大学长海医院眼科,上海市200433

出　　处：《眼科新进展》2008年第8期620-622,共3页Recent Advances in Ophthalmology

摘　　要：目的观察准分子激光屈光性角膜手术后激素性高眼压患者短时间药物干预后的眼压情况。方法回顾分析2004年5月至2006年2月我院眼屈光外科中心LASIK及LASEK手术病例。其中17例23眼术后眼压较术前眼压升高超过5mmHg（1kPa=7．5mmHg）。经短时间药物干预眼压降低至正常后。对眼压进行24-36个月的随访观察。结果23眼中激素中度反应性19眼，激素高反应性4眼，停用皮质类固醇滴眼液并短时间应用药物降眼压至正常，在24～36个月的随访中17眼眼压保持稳定，6眼眼压停药后短期内再次升高，在激素中度反应性19眼中有3眼眼压再次升高，发生率15．7％，在激素高反应性的4眼中发生眼压再次升高3眼，占75％；统计学分析差异有显著性。随访期内没有观察到视野和视盘的改变。结论皮质类固醇激素性高眼压早期应用药物降压后，多数患眼在近期及中长期随访中眼压稳定；激素高反应性患者近期眼压再次升高的发生率高于激素中度反应性患者。[眼科新进展2008；28（8）：620-622]Objective To evaluate long-term in- traoctdar pressure （IOP） for the corticosteroid-induced ocular hypertension after laser keratorefractive with short-term application of anti-glaucoma medications. Methods Twenty-three eyes of 17 patients who underwent LASIK or LASEK from May,2004 to February, 2006 and had steroid-induced elevation of IOP were evaluated retrospectively. IOP of 17 cases （23 eyes） increased more than5 mmHg（1 kPa=7.5 ram- Hg） as compared to preoperative values,and IOP reduced to normal level after receiving the short-term application of anti-glaucoma medications, and then followed up for 24 months to 36 months. Results In all 23 eyes the IOP elevation from 5 mmHg to 15 mmHg were 19 eyes and IOP increase of at least 15 mmHg were 4 eyes,after discontinuation of topical corticosteroids and application of anti-glaucoma medications IOP was decrease to normal levels, during the 24 months to 36 months follow-up IOP of 17 eyes remained stability and IOP of other 6 eyes was increased again in a relatively brief time,in the 19 eyes with IOP elevation from 5 mmHg to 15 mmHg there were 3 eyes which IOP was increased again,and in the 4 eyes with IOP increase of at least 15 mmHg there were 3 eyes （75%） which IOP was increased once more, there was difference statistically between them. During the follow-up, there were no glaucomatous optic neuropathy and visual field loss. Conclu. sion The IOP of most eyes for the corticosteroid-in- duced ocular hypertension after laser keratorefractive with short-term application of anti-glaucoma medica- tions are maintained in normal levels during the fol- low-up. The percentage of eyes with increase IOP once more in a relatively short time is more in high re- sponders than in intermediate responders. [ Rec Adv Ophthalmol 2008 ;28 （8） ：620-622 ]

关 键 词：激素性高眼压 准分子激光屈光性角膜手术 

分 类 号：R775[医药卫生—眼科]