中央孔型有晶状体眼人工晶状体植入术后早期眼压变化及相关影响因素  

Changes of intraocular pressure in the early stage after implantable collamer lens V4c implantation and related factors

作　　者：张裕琳 赵婧 周行涛 ZHANG Yulin;ZHAO Jing;ZHOU Xingtao(Department of Ophthalmology,Eye&ENT Hospital,Fudan University,NHC Key Laboratory of Myopia,Shanghai Research Center of Ophthalmology,Shanghai 200031,China;School of Medicine,Wenzhou Medical University,Wenzhou 325035,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,国家卫生健康委员会近视眼重点实验室,上海市眼视光学研究中心,上海200031 [2]温州医科大学医学院,温州325035

出　　处：《中国眼耳鼻喉科杂志》2021年第6期413-418,共6页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海申康医院发展中心临床三年行动计划(SHDC2020CR1043B)。

摘　　要：目的探讨中央孔型有晶状体眼人工晶状体(ICL)V4c植入术后早期眼压变化并分析相关影响因素。方法选择2020年7~8月于复旦大学附属眼耳鼻喉科医院视光中心行ICL V4c植入术的高度近视患者30例(59眼),术前行常规检查,术中记录黏弹剂使用情况,术后即刻、20 min、40 min、1 h、90 min、2 h、3 h、4 h采用非接触眼压计分别测量眼压,依据术后4 h内是否出现高眼压(≥21 mmHg,1 mmHg=0.133 kPa)分为高眼压组和正常眼压组进行对照研究,术后1 d、1周测视力、眼压、角膜内皮细胞、术后拱高、前房深度等,采用重复测量方差分析观察术后早期眼压变化规律,独立样本t检验或卡方检验比较高眼压组和正常眼压组的相关影响因素。结果术后4 h内出现短暂性高眼压34眼(57.62%),均在术后1~2 h出现眼压高峰值,其中有黏弹剂残留的,高眼压组14眼、正常眼压组2眼,差异有统计学意义(P<0.05)。术后一过性高眼压与炎症反应导致房水循环暂时性不畅相关。术后1 d、1周,98.3%术眼眼压均维持在正常范围内;术后1 d,91.5%术眼的裸眼视力达到或超过术前最佳矫正视力(BCVA),33.9%较术前BCVA提高1行及以上;术后1周,94.9%术眼的裸眼视力达到或超过术前BCVA,44.1%术眼BCVA较术前提高1行及以上。术后1 d,角膜内皮细胞计数与术前比较,差异无统计学意义(P>0.05);高眼压组与正常眼压组术后1周的角膜厚度、前房深度、屈光度及拱高比较,差异无统计学意义(P>0.05);术后1周内随访未出现继发性青光眼、角膜内皮细胞失代偿等并发症。结论中央孔型ICL植入术后早期眼压波动可控,术后4 h可出现眼压短暂性升高,与手术操作过程中有黏弹剂残留、早期炎症反应相关。Objective To investigate the changes of intraocular pressure(IOP)in the early stage after implantable collamer lens(ICL)V4c implantation and to analyze the related factors.Methods Thirty patients(59 eyes)with high myopia who underwent ICL V4c implantation at the Optometry Center of Eye&ENT Hospital of Fudan University from July to August 2020 were selected.Routine examinations were performed preoperatively,and intraoperative viscoelastic agent usage was recorded.IOP was measured using non-contact tonometer after surgery immediately,after 20 minutes,40 minutes,1 hour,90 minutes,2 hours,3 hours,4 hours,respectively.Visual acuity,IOP,corneal endothelium cell density(ECD),postoperative vault and anterior chamber depth(ACD)were measured at postoperative 1 day and 1 week.Repeated measurement analysis of variance was used to observe the IOP change,and the independent sample t-test or chi-square test were used to compare the related factors between the high IOP group and the normal IOP group.Results Temporary ocular hypertension occurred in 34 eyes(57.62%)within 4 hours after surgery,and the peak value of IOP occurred within 1 to 2 hours after surgery.There were 14 eyes with the viscoelastic agent residual in the high IOP group and 2 eyes with the viscoelastic agent residual in the normal IOP group,and the difference was statistically significant(P<0.05).One day and one week after operation,IOP of 98.3%eyes maintained within the normal range.One day after operation,the uncorrected distance visual acuity(UDVA)of 91.5%eyes reached or exceeded the preoperative best corrected visual acuity(BCVA),33.9%eyes improved by one line or more than the preoperative BCVA.One week after operation,UDVA of 94.9%eyes reached or exceeded the preoperative BCVA,and BCVA of 44.1%eyes improved by one line or more than preoperative level.There was no significant difference in the ECD between 1 day after operation and pre-operation.There were no significant differences in corneal thickness,ACD,refraction or vault between the high IOP group and th

关 键 词：眼压 有晶状体眼人工晶状体 近视 黏弹剂 拱高 

分 类 号：R779.6[医药卫生—眼科]