PDR玻璃体切除术后早期影响眼压的相关因素分析  

Proliferative diabetic retinopathy after vitrectomy early factors affect IOP

作　　者：刘世波[1] 张琦[1] 

机构地区：[1]辽宁医学院附属第一医院眼科,中国辽宁省锦州市121000

出　　处：《国际眼科杂志》2013年第5期883-886,共4页International Eye Science

摘　　要：目的:探讨增生性糖尿病视网膜病变(proliferative diabeticretinopathy,PDR)玻璃体切除术后早期引起眼压升高的可能原因。方法:选取行玻璃体切除术的72例100眼PDR患者进行回顾性分析,观察术后高眼压的发生率,并对引起术后高眼压的相关因素进行统计学分析。术后早期高眼压的诊断标准为:术后2wk内任何时间非接触性眼压计测眼压>25mmHg(1mmHg=0.133kPa)。结果:玻璃体切除术后27眼(27%)发生高眼压,其中男、女的发病率分别为27.27%和26.79%,两组比较差异无统计学意义(P>0.05)。眼内充填与平衡液充填组的发病率为30.95%和6.25%,两组比较差异有统计学意义(P<0.05)。硅油充填与C3F8充填组的发病率为34.28%和31.25%,两组比较差异无统计学意义(P>0.05)。术中行全视网膜光凝与补充视网膜光凝组的发病率为41%和20%,两组比较差异有统计学意义(P<0.05)。术前视网膜病变4期、5期、6期组的发病率分别为9.52%,23.81%,40.56%,各组比较差异有统计学意义(P<0.05)。术前未合并视网膜脱离与合并视网膜脱离组的发病率为19%和41%,两组比较差异有统计学意义(P<0.05)。术中联合晶状体切除术与术中未联合晶状体切除术组的发病率为34%和15%,两组比较差异有统计学意义(P<0.05)。经Logistic回归分析,术前合并视网膜脱离及术中眼内充填是引起玻璃体切除术后早期高眼压的独立危险因素。结论:PDR玻璃体切除术后眼压升高与术前合并视网膜脱离、术中联合晶状体切除、术中眼内充填、术中行全视网膜光凝相关,引起术后高眼压的独立危险因素为术前合并视网膜脱离、术中眼内充填。PDR玻璃体切除术后高眼压的发病率高,危害性大,早期发现并予个体化治疗可以增加玻璃体切除术的成功率,最大程度提高患者的视力。AIM：To explore possible causes of early postoperative elevated intraocular pressure caused by proliferative diabetic retinopathy （PDR） vitrectomy. METHODS： Totally 72 cases （100 eyes） which have performed vitrectomy for proliferative diabetic retinopathy were retrospectively analyzed to observe the incidence of postoperative ocular hypertension, and the relevant factors that caused postoperative high intraocular pressure were statistically analyzed. Early postoperative ocular hypertension diagnostic criteria： any time after 2 weeks of non-contact tonometer measured lOP〉 25mmHg （1 mmHg = 0. 133kPa）. RESULTS： High intraocular pressure after vitrectomy occurred in 27 eyes （27%）, the incidence of male and female were 27. 27%, 26. 79%, the difference was not statistically significant （ P〉0.05. Eyes filled with balanced liquid filling incidence rate of 30. 95%, 6.25%, and the ：lifference was statistically significant （P〈0.05）. Silicone 3il tamponade with C3F8 filled group incidence rate of ]4.28%, 31.25%, and the difference was not statistically significant （P〉0.05）. Incidences of intraoperative panretinal 3hotocoagulation and additional retinal photocoagulation aroup were 41%, 20%, and the difference was statistically ignificant （ P〈 0.05）. Preoperative retinopathy of four, ：ive, six groups of incidence were 9. 52%, 23. 81%,40.56%, and the groups were statistically significant （P〈 0. 05）. Unconsolidated preoperative retinal detachment and retinal detachment incidence rate of 19%, 41%, and the difference was statistically significant （P 〈 0. 05 ）. Surgery in the united lens resection with intraoperative unfederated lens the resection group＇s incidence rate of 34%, 15%, the difference was statistically significant （P〈 0.05）. Logistic regression analysis showed that retinal detachment preoperative and intraoperative intraocular filling were independent risk factors that caused early postoperative ocular hypertension after vitrectomy. CONCLUSION �

关 键 词：增生性糖尿病视网膜病变 玻璃体切除术 高眼压 

分 类 号：R779.6[医药卫生—眼科]