CAJ | 학술논문

目的：研究玻璃体切割术后早期及晚期眼压升高的发病率及病因。方法回顾分析235例（306眼）于我院行玻璃体切割术患者的临床资料，应用非接触式眼压计测量患者术前、术后早期（术后2周内）和术后晚期（术后6个月及以上）眼压，并分别对引起术后早期及术后晚期眼压升高的危险因素进行统计分析。结果306眼术前眼压平均值为（15.3±4.1）mmHg，随访时间6~20个月（平均14.3个月）。术后早期有42眼（13.7%）发生高眼压[平均值（31.9±6.0）mmHg]。术后晚期有12眼（3.9%）发生高眼压[平均值（32.1±5.7）mmHg]。Logistic回归分析结果显示：晶状体切除、巩膜环扎、睫状体光凝、惰性气体填充、硅油填充及糖尿病视网膜病变是术后早期发生高眼压的独立危险因素；晶状体切除、巩膜环扎、全视网膜光凝、硅油填充、糖尿病视网膜病变及颈动脉狭窄是术后晚期发生高眼压的独立危险因素，而光凝方式中睫状体光凝是术后晚期发生高眼压的保护因素。结论引起玻璃体切割术后发生高眼压与眼内填充物的不同、联合手术的方式、病种及颈动脉狭窄等有关。术后晚期眼压升高危害较大，术后晚期是否发生高眼压与早期高眼压无关。
목적：연구파리체절할술후조기급만기안압승고적발병솔급병인。방법회고분석235례（306안）우아원행파리체절할술환자적림상자료，응용비접촉식안압계측량환자술전、술후조기（술후2주내）화술후만기（술후6개월급이상）안압，병분별대인기술후조기급술후만기안압승고적위험인소진행통계분석。결과306안술전안압평균치위（15.3±4.1）mmHg，수방시간6~20개월（평균14.3개월）。술후조기유42안（13.7%）발생고안압[평균치（31.9±6.0）mmHg]。술후만기유12안（3.9%）발생고안압[평균치（32.1±5.7）mmHg]。Logistic회귀분석결과현시：정상체절제、공막배찰、첩상체광응、타성기체전충、규유전충급당뇨병시망막병변시술후조기발생고안압적독립위험인소；정상체절제、공막배찰、전시망막광응、규유전충、당뇨병시망막병변급경동맥협착시술후만기발생고안압적독립위험인소，이광응방식중첩상체광응시술후만기발생고안압적보호인소。결론인기파리체절할술후발생고안압여안내전충물적불동、연합수술적방식、병충급경동맥협착등유관。술후만기안압승고위해교대，술후만기시부발생고안압여조기고안압무관。
Objective To research the incidence and etiological factors of intraocular pressure(IOP)elevation in patients in early and late postop?erative stages after vitrectomy. Methods The clinical data of 235 cases(306 eyes)who underwent vitrectomy in our hospital were respectively ana?lyzed. IOP was measured before operation,in the early postoperative stage(within 2 weeks)and in the late postoperative stage(6 months after opera?tion or longer)by non?contact tonometer. Risk factors related with ocular hypertension happened in the early and late postoperative stages were statis?tically analyzed. Results The mean average IOP before operation was 15.3 ± 4.1 mmHg for the 306 eyes. Within the follow?up period of 6?20 months(mean,14.3 months),ocular hypertension occurred in 42 eyes[incidence,13.7%;mean,31.9 ± 6.0 mmHg]in the early postoperative stage and in 12 eyes[incidence,3.9%;mean,32.1 ± 5.7 mmHg]in the late postoperative stage. Logistic regression analysis revealed that lensecto?my,scleral buckling,cyclophotocoagulation,inert gas filling,silicone oil tamponade and diabetic retinopathy were the independent risk factors of oc?ular hypertension in early postoperative stage after vitrectomy,while lensectomy,scleral buckling,pan retinal photocoagulation,silicone oil tampon?ade,diabetic retinopathy and carotid artery stenosis were the independent risk factors of ocular hypertension in late postoperative stage after vitrecto?my. In addition,cyclophotocoagulation was a protective factor of IOP in the late postoperative stage. Conclusion The risk factors of ocular hyperten?sion after vitrectomy include the intraocular gapfiller,the mode of combined operation,disease type and carotid artery stenosis. IOP elevation that happens in the late postoperative stage is more harmful. Ocular hypertension in the late postoperative stage is not associated with that in the early stage.