高度近视有晶状体眼后房型人工晶状体植入术后早期高眼压的临床分析  

Clinical analysis of early ocular hypertension after posterior chamber intraocular lens implantation in cases with high myopia

作　　者：白燕慧[1] 周子喻 焦晓航 薛雯心 王卫群[1] Bai Yanhui;Zhou Ziyu;Jiao Xiaohang;Xue Wenxin;Wang Weiqun(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科、河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2023年第12期900-906,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：河南省重点研发与推广专项(科技攻关)项目(202102310073)。

摘　　要：目的分析高度近视有晶状体眼后房型人工晶状体(ICL)植入术后早期高眼压发生的原因。方法前瞻性病例系列研究。连续选取在郑州大学第一附属医院日间手术室2022年1月至10月行ICL植入术的高度近视83例(160只眼),对其临床资料进行分析。术前行常规检查,术后给予妥布霉素地塞米松滴眼液滴眼,观察术后早期眼压的变化。结果术后4 h有57只眼(35.63%)发生高眼压,其中39只眼裂隙灯显微镜下可见少量黏弹剂残留。眼压≥30 mmHg(1 mmHg=0.133 kPa)者4只眼,进行前房穿刺治疗后眼压恢复正常,其他53只眼未处理。术后1 d有22只眼(13.75%)发生高眼压,局部滴降眼压药物后眼压恢复正常。术后1周有13只眼(8.13%)发生高眼压,停用妥布霉素地塞米松滴眼液,局部滴降眼压药物后眼压恢复正常。眼压术后4 h[19.9(17.6,22.7)mmHg]及术后1 d[17.6(15.8,20.0)mmHg],均较术前[16.5(14.7,18.7)mmHg]高(均P<0.001);术后1周眼压[16.3(14.6,18.1)mmHg]与术前比较差异无统计学意义(P=1.000),术后各时间点眼压比较差异均有统计学意义(均P<0.05)。术后4 h有1例出现高眼压伴前房积血,术后3 d进行前房冲洗,前房积血消失,眼压恢复正常。结论高度近视ICL植入术后早期引起高眼压的原因不同,根据病因进行治疗眼压均可恢复正常。Objective To analyze the causes of early ocular hypertension after posterior chamber intraocular lens(ICL)implantation in patients with high myopia.Methods This was a prospective cohort study.Eighty-three cases(160 eyes)of high myopia who underwent ICL implantation in the daytime operating room of the First Affiliated Hospital of Zhengzhou University from Jan.2022 to Oct.2022 were selected consecutively,and their clinical data were analyzed.Routine examination before surgery were performed.Postoperative tobramycin and dexamethasone eye drops were applied.The changes in early postoperative intraocular pressure were observed.Results A total of 57 eyes(35.62%)developed high intraocular pressure at 4 hours after surgery.Under slit lamp observation,there were small amount of residual viscoelastic agents in 39 eyes.Among 57 eyes,4 eyes had an intraocular pressure of≥30 mmHg(1 mmHg=0.133 kPa),and after paracentesis treatment,the intraocular pressure returned to normal.The other 53 eyes had not been processed.At 1 day after surgery,22 eyes(13.75%)developed high intraocular pressure,which were brought normal by applying local drops of intraocular pressure lowering drugs.At 1 week after surgery,13 eyes(8.13%)developed high intraocular pressure.Tobramycin and dexamethasone eye drops were discontinued,and local intraocular pressure lowering drugs were used to restore normal intraocular pressure.The intraocular pressure at 4 hours after surgery[19.9(17.6,22.7)mmHg]and 1 day after surgery[17.6(15.8,20.0)mmHg]were significantly higher than that before surgery[16.5(14.7,18.7)mmHg](all P<0.001).There was no statistically significant difference in intraocular pressure between before surgery and 1 week after surgery[16.3(14.6,18.1)mmHg](P=1.000).There was a statistically significant difference in intraocular pressure at each time points after surgery(all P<0.05).During postoperative follow-up,there was 1 case of high intraocular pressure in the left eye accompanied by hyphema.At 3 days after surgery,anterior chamber flushing was

关 键 词：高度近视 有晶状体眼人工晶状体植入术 眼压 

分 类 号：R779.6[医药卫生—眼科]