有晶体眼后房型人工晶体植入术后稳定期高眼压发生的相关因素分析  

Influencing factors of high intraocular pressure during stable period after implantable collamer lens

作　　者：胡春明[1] 谢汉平[1] 汪辉[1] 罗启惠[1] 

机构地区：[1]第三军医大学西南医院全军眼科中心,重庆400038

出　　处：《第三军医大学学报》2012年第20期2108-2111,共4页Journal of Third Military Medical University

摘　　要：目的探讨有晶体眼后房型人工晶体(implantable collamer lens,ICL)植入术后稳定期发生高眼压的相关影响因素及治疗效果。方法收集2011年1-12月在我院行ICL植入术的79例(155眼)高度近视患者的临床资料,其中男性36例,女性43例,年龄18～46(23.84±6.54)岁。对术后1 d至6个月随访资料,包括眼压、裸眼远近视力、最佳矫正视力、屈光度(等效球镜值)、裂隙灯显微镜检查、房角镜检查、角膜内皮细胞计数、中央前房深度(central anterior chamberdepth,ACD)、晶体厚度、眼轴长度、术后拱高及小梁虹膜夹角(trabecular-iris angle,TIA)等进行分析。结果本组ICL植入术后出现稳定期高眼压8例16眼(10.3%,16/155),正常眼压71例(139眼)。87.5%的患者药物控制(14眼)效果良好,12.5%的患者(2眼)药物控制欠佳行手术治疗。手术前后ACD、术后拱高及术后TIA与术后稳定期高眼压发生密切相关(P<0.05,P<0.01),术后TIA是稳定期高眼压发生的独立影响因素。稳定期高眼压患者眼压和最佳矫正视力(best corrected visual acuity,BCVA)[(26.13±3.56)mmHg,(0.69±0.20)]与治疗后1周[(19.98±2.51)mmHg,(0.80±0.19)]、随访结束时(术后6个月)[(17.58±2.30)mmHg,(0.84±0.19)]比较差异显著(P<0.05,P<0.01)。结论 ICL植入术后稳定期高眼压的发生可能与植入的人工晶体与患眼匹配度欠佳所致长期慢性炎症有关。Objective To investigate influencing factors of high intraocular pressure（IOP） during stable period（1 to 3 months） after implantable collamer lens（ICL） and therapeutic efficacy.Methods Clinical data of 79 high myopia patients（155 eyes） who received ICL from January to December in 2011 were analyzed retrospectively.They were 36 males and 43 females,with an age ranging from 18 to 46（mean 23.84 ± 6.54）,and were followed up within 6 months post-operatively.IOP,uncorrected visual acuity,best corrected visual acuity,refractive diopter,slit lamp examination,gonioscopy,coneal endocellion,central anterior chamber depth（ACD）,lens thickness,axial length,vault and trabecular-iris angle（TIA） were observed and analyzed.Results Eight patients（16 eyes） experienced high IOP during stable period post-operatively with an incidence of 10.32%（16 /155）.Non-high IOP after ICL was found in 71 patients（139 eyes）.Fourteen eyes（87.5%） out of 16 eyes were treated with drops and good outcomes were obtained,but the left 2 eyes（12.5%） had to turn to surgery which were uncontrollable with drops.Pre-and post-operative ACD,post-operative vault and TIA were closely related to high IOP during stable period after ICL（P〈0.05,P〈0.01）.Post-operative TIA was an independent influencing factor for high IOP after ICL.IOP and best corrected visual acuity（BCVA） were 26.13 ± 3.56 mmHg and 0.69 ± 0.20 in stable period,19.98 ± 2.51 mmHg and 0.80 ± 0.19 in 1 week after treatment,and 17.58 ± 2.30 mmHg and 0.84 ± 0.19 at the end of follow-up.There were significant difference between those of the stable period with those of later 2 time points（P〈0.05,P〈0.01）.Conclusion High IOP during stable period after ICL may be related to not matching good enough between ICL and eye ball,which induces chronic inflammation for long time.

关 键 词：高度近视 后房型人工晶体植入术 高眼压 

分 类 号：R181.32[医药卫生—流行病学] R775[医药卫生—公共卫生与预防医学]