CAJ | 학술논문

目的分析后发性白内障行Nd∶YAG激光后囊切开术后出现急性眼压升高的临床处理及预后.方法回顾性系列病例研究.收集2012年1月-2013年11月我院眼科门诊因后发性白内障行Nd∶YAG激光后囊切开术后出现急性眼压升高(≥40 mmHg,1 mmHg=0.133 kPa)的16例患者病例资料,并对其年龄、性别、白内障类型、治疗前后视力和眼压、激光治疗参数、高眼压处理经过及预后进行总结.结果 16例患者平均年龄(22.5±11.8)岁,其中男10例,女性6例.激光治疗前眼压11～22 mmHg,平均(17.3±3.5)mmHg,有2例患者在接受抗青光眼药物治疗;激光治疗后(3.6±1.3)h患者眼压升高至40～57 mmHg,平均(44.1±4.5)mmHg.12例患者药物降眼压处理后眼压下降,4例患者在药物降眼压后眼压仍高于40 mmHg,行前房穿刺放液术控制眼压.术后第2天,除1例患者眼压31 mmHg,其余均在21 mmHg以内.术后第2天平均眼压(14.7±4.1)mmHg,恢复至治疗前水平.随访6个月,末次随访眼压12～20 mmHg,平均(16.3±2.8)mmHg,与激光治疗前眼压差异无统计学意义(t=1.240,P＞0.05).结论后发性白内障行Nd∶YAG激光后囊切开术后急性眼压升高患者可以通过药物和(或)前房穿刺放液术降眼压,效果和预后良好.
목적 분석후발성백내장행Nd∶YAG격광후낭절개술후출현급성안압승고적림상처리급예후.방법 회고성계렬병례연구.수집2012년1월-2013년11월아원안과문진인후발성백내장행Nd∶YAG격광후낭절개술후출현급성안압승고(≥40 mmHg,1 mmHg=0.133 kPa)적16례환자병례자료,병대기년령、성별、백내장류형、치료전후시력화안압、격광치료삼수、고안압처리경과급예후진행총결.결과 16례환자평균년령(22.5±11.8)세,기중남10례,녀성6례.격광치료전안압11～22 mmHg,평균(17.3±3.5)mmHg,유2례환자재접수항청광안약물치료;격광치료후(3.6±1.3)h환자안압승고지40～57 mmHg,평균(44.1±4.5)mmHg.12례환자약물강안압처리후안압하강,4례환자재약물강안압후안압잉고우40 mmHg,행전방천자방액술공제안압.술후제2천,제1례환자안압31 mmHg,기여균재21 mmHg이내.술후제2천평균안압(14.7±4.1)mmHg,회복지치료전수평.수방6개월,말차수방안압12～20 mmHg,평균(16.3±2.8)mmHg,여격광치료전안압차이무통계학의의(t=1.240,P＞0.05).결론 후발성백내장행Nd∶YAG격광후낭절개술후급성안압승고환자가이통과약물화(혹)전방천자방액술강안압,효과화예후량호.
Objective To analyze the clinical characteristics and prognosis of an acute intraocular pressure (IOP) spike posterior to the Nd∶YAG laser capsulotomy in patients with posterior capsular opacification.Methods Medical charts of 16 patients who underwent Nd ∶YAG laser capsulotomy and presented with an IOP spike (≥40 mmHg,1 mmHg=0.133 kPa) after treatment in Beijing Tongren Eye Center from January 2012 to November 2013 were reviewed retrospectively.Main investigative aspects included age,gender,cataract subtypes,pre-and post-treatment visual acuity and IOP,Nd∶YAG laser parameters used in the treatment,the management of the acute IOP elevation and the clinical outcomes.Results Sixteen patients (10 males and 6 females) were enrolled in this retrospective study,with an average age of 22.5±11.8 years.Mean IOP level was 17.3±3.5(11-22)mmHg before laser capsulotomy.Two of the patients were receiving anti-glaucoma medication before the laser treatment.IOP increased immensely 3.6±1.3(2-6) hours after posterior laser capsulotomy,with an average of 44.1±4.5(40-57)mmHg.IOP was controlled in 12 patients after intensive anti-glaucoma medication.Nevertheless,the other four patients still had high IOP above 40 mmHg after medical intervention,and paracentisis was performed to reduce ocular hypertension.Except for one patient who still had an IOP of 31 mmHg,IOP was under control (≤ 21 mmHg) in all other patients by the second day.On follow-up day 3,IOP was 14.7±4.1(11-19)mmHg.IOP remained stable and was 16.3±2.8(12-20)mmHg on the last follow-up visit,which was not statistically different from baseline (t=1.240,P＞0.05).Conclusion Intensive anti-glaucoma medication and/or paracentisis is safe and effective to reverse the IOP spike in patients with posterior capsular opacification posterior to Nd∶YAG laser capsulotomy.And the prognosis is excellent.