玻璃体切割联合白内障超声乳化手术后的近期眼压改变  

Short-term change of intraocular pressure after vitrectomy combined phacoemulsification

作　　者：李纳[1] 马凯[1] 崔蕊[1] 

机构地区：[1]首都医科大学附属北京同仁医院 北京同仁眼科中心 北京市眼科学与视觉科学重点实验室,100730

出　　处：《眼科》2012年第4期264-267,共4页Ophthalmology in China

摘　　要：目的探讨玻璃体切割联合白内障超声乳化摘除人工晶状体(IOL)植入术后的近期眼压改变。设计回顾性比较性病例系列。研究对象2010年北京同仁医院眼科住院施行玻璃体切割术的连续病例102例106眼。方法回顾因玻璃体积血或黄斑疾病行标准20G玻璃体切割联合(30例32眼)或不联合(70例74眼)白内障超声乳化摘除IOL植入术的病例资料,排除患有其他可能影响眼压的疾病者。比较两组间术后3天的眼压变化情况。主要指标眼压值。结果联合白内障手术组与单纯玻璃体切割术组相比,术前眼压分别为(13.8±3.9)和(14.5±3.0)mm Hg,无显著性差异(P=0.319);术后第1天(16.4±9.1)、(16.4±9.1)mmHg,第2天(13.9±5.6)、(14.7±5.1)mm Hg,第3天(13.1±4.4)、(13.8±4.6)mm Hg的平均眼压均无显著性差异(P均>0.05)。但单纯玻璃体切割术组术后第1天平均眼压较术前显著升高。两组术后高眼压发生率(15.6%、27.1%)无显著差别,80%和90%发生于术后第1天。联合手术组中术后高眼压(5眼)均为糖尿病视网膜病变者。结论联合白内障超声乳化手术并不显著增加玻璃体切割手术后的近期眼压水平及高眼压发生率。Objective To evaluate the short-term change of intraocular pressure （lOP） after vitrectomy combined with phacoemul- sification and intraocular lens （IOL） implantation. Design Retrospective comparative eases series. Participants 106 eyes of 102 consec- utive inpatients who had undergone vitrectomy in Department of Ophthalmology, Beijing Tongren Hospital in 2010. Methods The cases with vitreous hemorrhage/opacity or macular disease who had undergone standard 20 gauge pars plana vitrectomy combined with pha- coemulsification and intraocular lens implantation （32 eyes of 30 patients） or without （74 eyes of 70 patients）, excluding the cases with preoperative medical history of any possible effects on IOP. Main Outcome Measures lOP. Results Compared the combined cataract operation group with single vitrectomy group, the preoperative lOP （13.8±3.9, 14.5±3.0 mm Hg） had no significant difference （P=0.319）, the average lOP of postoperative day 1 （16.4±9.1, 16.4±9.1 mm Hg）, day 2 （13.9±5.6, 14.7±5.1 mm Hg） and day 3 （13.1±4.4, 13.8±4.6 mm Hg） had no significant difference （P〉0.05 for each）. Average lOP of postoperative day 1 was significantly higher than the preopera- tive one in the single vitrectomy group. Postoperative ocular hypertension incidence （15.6% vs 27.1%） in the two groups had no signifi- cant difference, which both mainly （80% vs 90%） occurred on the first postoperative day. All the five cases with ocular hypertension in the combined group occurred in eyes with diabetic retinopathy. Conclusion Combined with cataract surgery does not significantly in- crease the recent lOP and the incidence of ocular hypertension after vitreetomy, （Ophthalmol CHN, 2012, 21： 264-267）

关 键 词：玻璃体切割术 白内障摘除术 眼压 

分 类 号：R779.6[医药卫生—眼科]