白内障术中突发高眼压的应急处理措施  

Emergency treatment for sudden high intraocular pressure during cataract surgery

作　　者：李月华[1] 卢弘[1] 张孝生[1] 律学彦[1] 许卓再[1] 李上[1] 

机构地区：[1]首都医科大学附属北京朝阳医院眼科,北京市100020

出　　处：《眼科新进展》2010年第3期262-264,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨白内障超声乳化术、小切口白内障非超声乳化术中突发高眼压应急处理措施。方法选取白内障超声乳化术、小切口白内障非超声乳化术术中突发高眼压患者共35例(35眼),采用睫状体扁平部玻璃体水囊抽吸术或前部玻璃体切割术等应急措施,比较术前与应急处理后视力、眼压、前房深度及处理后并发症情况。结果32眼(91.4%)应急处理后最佳矫正视力高于术前。术前平均眼压为(18.37±2.13)mmHg(1kPa=7.5mmHg),应急处理后平均眼压为(17.40±1.89)mmHg,二者比较差异有统计学意义(P=0.02);术前平均前房深度为(2.93±0.50)mm,应急处理后平均前房深度(3.13±0.56)mm,二者比较差异有统计学意义(P=0.04)。应急处理后并发症包括玻璃体少量积血1眼,脉络膜脱离1眼,视网膜出血2眼,未发现高眼压、浅前房等。结论睫状体扁平部玻璃体水囊抽吸术或前部玻璃体切割术是控制白内障术中突发高眼压的积极有效的措施。Objective To investigate the emergency treatment of sudden high intraocular pressure（IOP） during phacoemulsification and small-incision non-phacoemulsification on cataract patients.Methods Thirty-five patients（35 eyes） with sudden high IOP during phacoemulsification and small-incision non-phacoemulsification were chosen.The emergency treatments of pars plana vitreous water-bag aspiration or anterior vitrectomy were performed,the change of visual acuity,IOP and anterior chamber depth were compared before surgery and after the emergency treatment.Results The best corrected visual acuity in 32 eyes （91.4%） after the emergency treatment was better than that before surgery.The mean IOP before surgery and after the emergency treatment were （18.37±2.13）mmHg（1 kPa=7.5 mmHg）,（17.40±1.89）mmHg respectively,there was statistical difference（P=0.02）.The mean anterior chamber depth before surgery and after the emergency treatment were （2.93±0.50）mm and （3.13±0.56）mm,there was statistical difference（P=0.04）.The complications after the emergency treatment included little vitreous hemorrhage in 1 eye,choroidal detachment in 1 eye and retinal hemorrhage in 2 eyes,no high IOP and shallow of anterior chamber was found.Conclusion Pars plana vitreous water-bag aspiration or anterior vitrectomy is the effective emergent option for sudden high IOP during cataract surgery.

关 键 词：白内障 瞳孔阻滞 高眼压 

分 类 号：R776.1[医药卫生—眼科]