玻璃体视网膜手术后高眼压的临床分析及处理  

Risk factors and management of high intraocular pressure after vitreoretinal surgery

作　　者：陈彬[1] 韩宇[1] 叶宏权 张海涛[1] 

机构地区：[1]四川省乐山市人民医院眼科,614000

出　　处：《临床眼科杂志》2013年第5期428-430,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨玻璃体视网膜手术后高眼压的原因及其处理方法。方法回顾性分析209例（209只眼）经玻璃体视网膜手术联合不同眼内填充物、行或不行巩膜环扎、有或无晶状体、有或无眼外伤对术后高眼压发生的原因，分别进行药物或手术治疗。结果76只眼术后第1天发生高眼压，发生率为36．4％。26只眼术后1周内高眼压，发生率为12．4％。术后2-4周11只眼高眼压，发生率为5．3％。其中联合巩膜环扎组和未行巩膜环扎组、无晶状体眼和有晶状体眼、外伤组和非外伤组术后高眼压发生率差异有统计学意义（P〈0．05），而C3F8填充组和硅油填充组高眼压发生率差异无统计学意义（P〉0．05）。结论玻璃体视网膜手术后发生高眼压受多因素作用所致，无晶状体眼、巩膜环扎、眼外伤等为其高危因素。术前、术中对一些可控因素进行有效预防、术后监测眼压可早期发现并及时进行药物、手术治疗，可有效控制眼压。Objective To investigate the etiology and management of high intraccular pressure （IOP ） in patients after vitreoretinal surgery. Methods This is a retrospective case series study. Totally 209 patients （ 209 eyes ） received vitreoretinal surgery and intraecular tampenade, with or without scleral buckling and lens extraction. We reviewed the effect of different types of intraecular tampenade, acleral buckling, lens excision, and ocular trauma on postoperative intraccular pressure （ IOP）, and the outcomes of medication or surgery treatment for high IOP. Results There were 76 cases （ 76 eyes） suffered high intraecular pressure on the first day after surgery. The incidence was 36.4%. At 1 week, there were 26 cases （26 eyes ） had high IOP and the incidence rate was 12.4%. By 2 to 4 weeks, the incidence rate of high intraccular pressure fell to 5.3% （ 11 cases）. There were significant differences in the incidence rate between the patients with or without scleral buckling, lens extractions or ocular trauma. But C3F8 filling or silicone oil tampenade did not affect the incidence of high lOP. Conclusion Many factors can lead to postoperative high IOP after vitreoretinal surgery. Among them, trauma, tamponade, aphakia, sdera buckling are recognized as most common risk factors. Healthcare teams should pay attention to these risk factors, and monitor and treat high IOP closely.

关 键 词：玻璃体视网膜手术 高眼压 原因 处理 

分 类 号：R779.6[医药卫生—眼科]