玻璃体切除术后早期眼压变化及术后高眼压影响因素分析  

Early intraocular pressure changes after vitrectomy and factors associated with intraocular hypertension

作　　者：李燕[1] 梅丽娜[1] 邓丽琴[1] 乔瑞芳 侯豹可[1] LI Yan;MEI Li’na;DENG Liqin;QIAO Ruifang;HOU Baoke(Senior Department of Ophthalmology,the Third Medical Center,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心眼科医学部,北京100039

出　　处：《解放军医学院学报》2022年第10期1036-1039,共4页Academic Journal of Chinese PLA Medical School

基　　金：北京市科技计划项目(Z211100002921049)。

摘　　要：背景玻璃体视网膜手术后的眼压升高是术后早期最常见并发症,如不能及时发现和处理,可能会损害视神经而导致不可逆的视功能丧失。目的探讨玻璃体切除术后早期眼压变化及高眼压发生率,并分析其影响因素。方法选择2020年7月-2022年2月在我中心行玻璃体切除手术患者,连续检测术后3 d的眼压,分析患者年龄、性别、原发病、手术方式、眼内硅油填充等对手术后早期发生高眼压的影响。结果共纳入406例患者(419眼),男234例(247眼),女172例(172眼),年龄3~91(52.60±15.69)岁。术前眼压平均为(13.7±3.6)mmHg(1 mmHg=0.133 kPa),术后第1、2、3天平均眼压分别为(16.2±6.4)mmHg、(16.0±6.3)mmHg、(16.0±6.0)mmHg,术后前3 d内眼压平均值均高于术前眼压值(P均<0.01)。玻璃体切除术后3 d内,56只眼发生早期高眼压,发生率13.4%。高眼压发生平均时间(1.47±0.67)d。多因素logistic回归分析表明患者合并糖尿病[OR(95%CI):2.266(1.229~4.177)]、术中光凝[OR(95%CI):3.797(1.845~7.813)]与术后早期高眼压独立关联。结论玻璃体切除术后早期易发生高眼压,尤其对于合并糖尿病、术中需要光凝的患者,术后应密切观察眼压变化。Background High intraocular pressure is still the most common complication in the early postoperative period after vitreoretinal surgery,which may damage the optic nerve and lead to irreversible loss of visual function if not detected and treated in time.Objective To investigate the change of intraocular pressure and incidence of high intraocular pressure after vitrectomy and analyze its associated factors.Methods Patients who underwent vitrectomy in our hospital from July 2020 to February 2022 were selected.The intraocular pressure was measured at 3 days after the operation,and the effect of age,gender,primary disease,surgical method,and intraocular silicone oil tamponade on early postoperative intraocular hypertension were analyzed.Results A total of 406 patients(419 eyes)were selected.Of the 406 cases,234 cases(57.6%)were male(247 eyes)and 172 cases(42.4%)were female(172 eyes).The average age of patients at time of surgery was(52.60±15.69)years,ranging from 3 to 91 years.The average intraocular pressure at 1 day,2 days,3 days after operation was higher than that of eyes before operation(16.2±6.4 mmhg,16.0±6.3 mmhg,16.0±6.0 mmhg vs 13.7±3.6 mmhg,P<0.01,respectively).Within 3 days after vitrectomy,56 eyes developed early intraocular hypertension,the incidence rate was 13.4%,and the average time of intraocular hypertension was 1.47±0.67 days.Multivariate logistic regression analysis showed that diabetic(OR[95%CI]:2.266[1.229-4.177]),photocoagulation(OR[95%CI]:3.797[1.845-7.813])were independently associated with occurrence of early postoperative ocular hypertension.Conclusion Early Intraocular hypertension is prone to occur after vitrectomy,especially for patients with diabetes or intraoperative photocoagulation,and intraocular pressure changes should be closely observed after vitrectomy.

关 键 词：玻璃体切除手术 硅油填充 术后并发症 高眼压 影响因素 

分 类 号：R779.6[医药卫生—眼科]