中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2011年
3期
250-252
,共3页
谈旭华%武志峰%张清%邹文军
談旭華%武誌峰%張清%鄒文軍
담욱화%무지봉%장청%추문군
高眼压%玻璃体视网膜手术%手术后并发症
高眼壓%玻璃體視網膜手術%手術後併髮癥
고안압%파리체시망막수술%수술후병발증
Intraocular pressure evleation%Vitreoretinal surgery%Postoperative complications
目的 探讨玻璃体视网膜术后高眼压的发病率、相关危险因素及治疗方法.方法 采用前瞻性临床研究,对112例玻璃体视网膜术后患者进行随访,采用非接触眼压计测量术前、术后7d、2周、1月眼压,对高眼压患者进行药物治疗、前房穿刺或手术治疗.结果 术后26例(23.2%)发生高眼压.术中行硅油填充、C3F8填充术后高眼压发病率为23.8%,23.5%.行巩膜环扎和未行巩膜环扎术后高眼压发病率为33.3%,21.6%.术中行晶体摘除和未行晶体摘除高眼压发病率为28.5%,19.6%.PVRC2及以上组和PVRC2以下组高眼压发病率为35.1%,15.9%.高眼压多发生于术后1周内,占80.8%.1周后出现高眼压为5例,占19.2%.高眼压持续时间1d,2d,3d和1周以下,1周以上各为30.8%,23.1%,11.5%和88.5%,11.5%.经logistic回归分析高眼压的危险因素为合并外伤、糖尿病、PVR、眼内手术史、术中联合环扎、眼内填充.结论 眼压升高是玻璃体切除手术后常见并发症,危险因素有外伤、糖尿病、PVR、眼内手术史、术中联合环扎、眼内填充.药物治疗和前房穿刺可有效降低眼压.
目的 探討玻璃體視網膜術後高眼壓的髮病率、相關危險因素及治療方法.方法 採用前瞻性臨床研究,對112例玻璃體視網膜術後患者進行隨訪,採用非接觸眼壓計測量術前、術後7d、2週、1月眼壓,對高眼壓患者進行藥物治療、前房穿刺或手術治療.結果 術後26例(23.2%)髮生高眼壓.術中行硅油填充、C3F8填充術後高眼壓髮病率為23.8%,23.5%.行鞏膜環扎和未行鞏膜環扎術後高眼壓髮病率為33.3%,21.6%.術中行晶體摘除和未行晶體摘除高眼壓髮病率為28.5%,19.6%.PVRC2及以上組和PVRC2以下組高眼壓髮病率為35.1%,15.9%.高眼壓多髮生于術後1週內,佔80.8%.1週後齣現高眼壓為5例,佔19.2%.高眼壓持續時間1d,2d,3d和1週以下,1週以上各為30.8%,23.1%,11.5%和88.5%,11.5%.經logistic迴歸分析高眼壓的危險因素為閤併外傷、糖尿病、PVR、眼內手術史、術中聯閤環扎、眼內填充.結論 眼壓升高是玻璃體切除手術後常見併髮癥,危險因素有外傷、糖尿病、PVR、眼內手術史、術中聯閤環扎、眼內填充.藥物治療和前房穿刺可有效降低眼壓.
목적 탐토파리체시망막술후고안압적발병솔、상관위험인소급치료방법.방법 채용전첨성림상연구,대112례파리체시망막술후환자진행수방,채용비접촉안압계측량술전、술후7d、2주、1월안압,대고안압환자진행약물치료、전방천자혹수술치료.결과 술후26례(23.2%)발생고안압.술중행규유전충、C3F8전충술후고안압발병솔위23.8%,23.5%.행공막배찰화미행공막배찰술후고안압발병솔위33.3%,21.6%.술중행정체적제화미행정체적제고안압발병솔위28.5%,19.6%.PVRC2급이상조화PVRC2이하조고안압발병솔위35.1%,15.9%.고안압다발생우술후1주내,점80.8%.1주후출현고안압위5례,점19.2%.고안압지속시간1d,2d,3d화1주이하,1주이상각위30.8%,23.1%,11.5%화88.5%,11.5%.경logistic회귀분석고안압적위험인소위합병외상、당뇨병、PVR、안내수술사、술중연합배찰、안내전충.결론 안압승고시파리체절제수술후상견병발증,위험인소유외상、당뇨병、PVR、안내수술사、술중연합배찰、안내전충.약물치료화전방천자가유효강저안압.
Objective To investigate the incidence,risk factors and treatments of intraocular pressure elevation following vitreoretinal surgery.Methods A total of 112 patients who underwent vitreoretinal surgery were prospectively observed.IOPs were measured before surgery and at lweek (everyday),2 weeks,1 month after surgery with non-touch tonometry examination.The patients with intraocular pressure elevation were treated by medication,anterior chamber paracentesis and surgery.Results The IOP elevation occurred in 26patients after operation (23.2%).The rate of IOP elevation with intraocular tamponade of C3F8 or silicone oil was 23.8% or 23.5%.The rate of IOP elevation in sclera buckling was 33.3% and 21.6% for no sclera buckling.The rate of IOP elevation in aphakia was 28.5% and 19.6% for phakia.The rate of IOP elevation in patients with proliferative vitreoretinopathy (PVR) ≥ gradeC2 was 35.1% and 15.9 % for ≤ gradeC2.The IOP elevation occurred mostly within 1 week (80.8%).Through the logistic regression analysis,the risk factors of IOP elevation include trauma,diabetes,proliferative vitreoretinopathy,intraocular surgery history,sclera buckling and intraocular tamponade.Conclusions IOP elevation is a common complication of vitreoretinal surgery.The risk factors of ocular hypertension include trauma,diabetes,proliferative vitreoretinopathy,intraocular surgery history,sclera buckling and intraocular tamponade.Most ocular hypertension following vitreoretinal surgery can be effectively treated by medication and anterior chamber paracentesis.
