国际眼科杂志
國際眼科雜誌
국제안과잡지
International Eye Science
2015年
12期
2110-2113
,共4页
周玉娟%张杰%孙先勇%于鹏林%娄华东
週玉娟%張傑%孫先勇%于鵬林%婁華東
주옥연%장걸%손선용%우붕림%루화동
高度近视%黄斑裂孔%玻璃体切割术%高眼压%拉坦前列腺素
高度近視%黃斑裂孔%玻璃體切割術%高眼壓%拉坦前列腺素
고도근시%황반렬공%파리체절할술%고안압%랍탄전렬선소
high myopia%macular hole%pars plana vitrectomy%high intraocular pressure%latanoprost eye drops
目的：通过观察高度近视性黄斑裂孔不伴视网膜脱离患者行玻璃体切割术后早期发生高眼压应用降压药物的疗效，以明确单独或联合应用拉坦前列素滴眼液的降压效果。<br> 方法：于我院行23G玻切联合C3 F8注入的高度近视性黄斑裂孔不伴视网膜脱离患者188例205眼；监测术后1wk内的眼压。当眼压介于22～29 mmHg时设为A组，随机加用盐酸卡替洛尔滴眼液（ A1组）或拉坦前列素滴眼液（ A2组）；当介于30～39mmHg时设为B组，随机加用盐酸卡替洛尔滴眼液＋酒石酸溴莫尼定滴眼液（ B1组）或盐酸卡替洛尔滴眼液＋拉坦前列腺素滴眼液（ B2组）；当高及40 mmHg及以上时，设为 C组，20％甘露醇快速静脉滴注1次，并随机加用盐酸卡替洛尔滴眼液＋酒石酸溴莫尼定滴眼液＋布林佐胺滴眼液（ C1组）或盐酸卡替洛尔滴眼液＋酒石酸溴莫尼定滴眼液＋拉坦前列腺素滴眼液（ C2组）。连续观察3d，眼压降至21mmHg及以下时则视为有效，比较不同用药3d内的降压有效率、降压幅度及平均有效作用时间。<br> 结果：符合研究标准的术后高眼压共89眼，发生于前3 d共70眼（78．6％）。 A组共31眼， A1组14眼， A2组17眼；有效例数分别为5例（35．7％）、13例（76．5％），差异有统计学意义（χ2＝5．24，P＝0．03）；降压幅度分别为4．21±1．22mmHg（24％）、8．76±3．03mmHg（29．6％），差异有统计学意义（t＝5．73，P＜0．05）；平均有效作用时间分别为2．80±0．45、2．08±0．49d，差异有统计学意义（ t＝2．85，P＝0．012）。 B组共32眼，B1组17眼，B2组15眼，有效例数分别为9例（52．9％）、11例（73．3％），差异无统计学意义（χ2＝1．40，P＝0．30）；降压幅度分别为10．59±2．72mmHg （36．9％）、16．53±2．67mmHg（43．8％），差异有统计学意义（t＝6．27，P＜0．05）；平均有效作用时间分别为2．56±0.53、1．63±0．67d，差异有统计学意义（ t＝3．34， P＝0.004）。 C组共26眼，C1组14眼，C2组12眼，有效例数分别为9例（64．3％）、8例（66．7％），差异无统计学意义（ P＝0.70）；降压幅度分别为22．00 mmHg （51．0％）、31.45mmHg（59．3％），差异有统计学意义（t＝18．35，P＜0.05）；平均有效作用时间分别为2．63±0．52、1．80±0.63d，差异有统计学意义（t＝2．97，P＝0．009）。<br> 结论：高度近视性黄斑裂孔玻璃体切割术后伴发高眼压的比率较高，一般发生在术后3d内，单独或联合应用拉坦前列素滴眼液可以有效降低眼压。
目的：通過觀察高度近視性黃斑裂孔不伴視網膜脫離患者行玻璃體切割術後早期髮生高眼壓應用降壓藥物的療效，以明確單獨或聯閤應用拉坦前列素滴眼液的降壓效果。<br> 方法：于我院行23G玻切聯閤C3 F8註入的高度近視性黃斑裂孔不伴視網膜脫離患者188例205眼；鑑測術後1wk內的眼壓。噹眼壓介于22～29 mmHg時設為A組，隨機加用鹽痠卡替洛爾滴眼液（ A1組）或拉坦前列素滴眼液（ A2組）；噹介于30～39mmHg時設為B組，隨機加用鹽痠卡替洛爾滴眼液＋酒石痠溴莫尼定滴眼液（ B1組）或鹽痠卡替洛爾滴眼液＋拉坦前列腺素滴眼液（ B2組）；噹高及40 mmHg及以上時，設為 C組，20％甘露醇快速靜脈滴註1次，併隨機加用鹽痠卡替洛爾滴眼液＋酒石痠溴莫尼定滴眼液＋佈林佐胺滴眼液（ C1組）或鹽痠卡替洛爾滴眼液＋酒石痠溴莫尼定滴眼液＋拉坦前列腺素滴眼液（ C2組）。連續觀察3d，眼壓降至21mmHg及以下時則視為有效，比較不同用藥3d內的降壓有效率、降壓幅度及平均有效作用時間。<br> 結果：符閤研究標準的術後高眼壓共89眼，髮生于前3 d共70眼（78．6％）。 A組共31眼， A1組14眼， A2組17眼；有效例數分彆為5例（35．7％）、13例（76．5％），差異有統計學意義（χ2＝5．24，P＝0．03）；降壓幅度分彆為4．21±1．22mmHg（24％）、8．76±3．03mmHg（29．6％），差異有統計學意義（t＝5．73，P＜0．05）；平均有效作用時間分彆為2．80±0．45、2．08±0．49d，差異有統計學意義（ t＝2．85，P＝0．012）。 B組共32眼，B1組17眼，B2組15眼，有效例數分彆為9例（52．9％）、11例（73．3％），差異無統計學意義（χ2＝1．40，P＝0．30）；降壓幅度分彆為10．59±2．72mmHg （36．9％）、16．53±2．67mmHg（43．8％），差異有統計學意義（t＝6．27，P＜0．05）；平均有效作用時間分彆為2．56±0.53、1．63±0．67d，差異有統計學意義（ t＝3．34， P＝0.004）。 C組共26眼，C1組14眼，C2組12眼，有效例數分彆為9例（64．3％）、8例（66．7％），差異無統計學意義（ P＝0.70）；降壓幅度分彆為22．00 mmHg （51．0％）、31.45mmHg（59．3％），差異有統計學意義（t＝18．35，P＜0.05）；平均有效作用時間分彆為2．63±0．52、1．80±0.63d，差異有統計學意義（t＝2．97，P＝0．009）。<br> 結論：高度近視性黃斑裂孔玻璃體切割術後伴髮高眼壓的比率較高，一般髮生在術後3d內，單獨或聯閤應用拉坦前列素滴眼液可以有效降低眼壓。
목적：통과관찰고도근시성황반렬공불반시망막탈리환자행파리체절할술후조기발생고안압응용강압약물적료효，이명학단독혹연합응용랍탄전렬소적안액적강압효과。<br> 방법：우아원행23G파절연합C3 F8주입적고도근시성황반렬공불반시망막탈리환자188례205안；감측술후1wk내적안압。당안압개우22～29 mmHg시설위A조，수궤가용염산잡체락이적안액（ A1조）혹랍탄전렬소적안액（ A2조）；당개우30～39mmHg시설위B조，수궤가용염산잡체락이적안액＋주석산추막니정적안액（ B1조）혹염산잡체락이적안액＋랍탄전렬선소적안액（ B2조）；당고급40 mmHg급이상시，설위 C조，20％감로순쾌속정맥적주1차，병수궤가용염산잡체락이적안액＋주석산추막니정적안액＋포림좌알적안액（ C1조）혹염산잡체락이적안액＋주석산추막니정적안액＋랍탄전렬선소적안액（ C2조）。련속관찰3d，안압강지21mmHg급이하시칙시위유효，비교불동용약3d내적강압유효솔、강압폭도급평균유효작용시간。<br> 결과：부합연구표준적술후고안압공89안，발생우전3 d공70안（78．6％）。 A조공31안， A1조14안， A2조17안；유효례수분별위5례（35．7％）、13례（76．5％），차이유통계학의의（χ2＝5．24，P＝0．03）；강압폭도분별위4．21±1．22mmHg（24％）、8．76±3．03mmHg（29．6％），차이유통계학의의（t＝5．73，P＜0．05）；평균유효작용시간분별위2．80±0．45、2．08±0．49d，차이유통계학의의（ t＝2．85，P＝0．012）。 B조공32안，B1조17안，B2조15안，유효례수분별위9례（52．9％）、11례（73．3％），차이무통계학의의（χ2＝1．40，P＝0．30）；강압폭도분별위10．59±2．72mmHg （36．9％）、16．53±2．67mmHg（43．8％），차이유통계학의의（t＝6．27，P＜0．05）；평균유효작용시간분별위2．56±0.53、1．63±0．67d，차이유통계학의의（ t＝3．34， P＝0.004）。 C조공26안，C1조14안，C2조12안，유효례수분별위9례（64．3％）、8례（66．7％），차이무통계학의의（ P＝0.70）；강압폭도분별위22．00 mmHg （51．0％）、31.45mmHg（59．3％），차이유통계학의의（t＝18．35，P＜0.05）；평균유효작용시간분별위2．63±0．52、1．80±0.63d，차이유통계학의의（t＝2．97，P＝0．009）。<br> 결론：고도근시성황반렬공파리체절할술후반발고안압적비솔교고，일반발생재술후3d내，단독혹연합응용랍탄전렬소적안액가이유효강저안압。
?AIM:To study the effect of only latanoprost eye drops or combined with other medicines on lowering intraocular pressure(IOP) after early pars plana vitrectomy(PPV) for macular hole without retinal detachment caused by high myopia. <br> ?METHODS:One hundred and eighty-eight cases ( 205 eyes) suffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C3 F8 tamponade were studied retrospectively and measured the IOP at 1wk after surgeries.The patients whose IOP was 22 ~29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1 ( treated by carteolol eye drops ) and subgroup A2 ( treated by latanoprost eye drops ) . The patients whose IOP was 30 ~39 mmHg were named as group B. Then they were divided randomly into two subgroups, group B1 ( treated by both carteolol and brimonidine tartrate eye drops ) and subgroup B2 ( treated by both latanoprost and carteolol eye drops) .The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20%Mannitol.Meanwhile, they were divided randomly into two subgroups, group C1 ( treated by carteolol, brimonidine tartrate and brinzolamide eye drops ) and subgroup C2 ( treated by carteolol, brimonidine tartrate and latanoprost eye drops ) . Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid.And then,compare the effectiveness, IOP reduction and the average effective duration. <br> ?RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes ( 78.6%) increased within 3d after operations.There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5 ( 35.7%) and 13 ( 76.5%) respectively, the difference was statistically significant(χ2 =5.24, P=0.03 ) .The IOP reduction of the two groups were 4.21 ±1.22mmHg ( 24%), 8.76 ± 3.03mmHg(29.6%) , respectively, and the difference was statistically significant ( t=5.73, P<0.05).The average effective duration of the two group were 2.80±0.45, 2.08± 0.49d, respectively, and the difference was statistically significant(t=2.85,P=0.012).There were 32 eyes in group B including 17 eyes in group B1 and 15 eyes in group B2. The number of effective cases of the two groups was 9 (52.9%)and 11(73.3%),respectively, and the difference was not statistically significant(χ2 =1.40,P=0.30 ).The IOP reduction of the two groups was 10.59 ±2.72mmHg (36.9%), 16.53±2.67mmHg(43.8%)respectively, and the difference was statistically significant(t=6.27,P<0.05). The average effctive duration of the two group was 2.56 ± 0.53, 1.63 ±0.67d respectively, and the difference was statistically significant(t=3.34,P=0.004).There were 26 eyes in group C including 14 eyes in group C1 and 12 eyes in group C2.The number of effective cases of the two groups was 9 (64.3%) and 8(66.7 %) respectively, and the difference was not statistically significant(P=0.70). The IOP reduction of the two groups was 22.00mmHg (51.0%), 31.45mmHg ( 59.3%) respectively, and the difference was statistically significant(t=18.35,P<0.05). The average effctive duration of the two group was 2.63 ± 0.52, 1.80 ±0.63d respectively, and the difference was statistically significant(t=2.97,P=0.009). <br> ?CONCLUSION:PPV treating macular hole caused by high myopia is associated with highe rates of IOP increasing, which generally occurs within 3d after the operation. Alone or in combination, latanoprost eye drops can effectively reduce IOP.
