玻璃体切割联合眼内填充术后早期高眼压的临床分析

Correlated factors and treatment of high intraocular pressure after vitrectomy combined with intraocular tamponade

目的分析玻璃体切割联合眼内填充术后早期高眼压的相关危险因素,为临床治疗和预防提供依据。方法回顾性分析2011年3月至2014年3月在本院连续接受玻璃体切割联合眼内填充术的113例患者的临床资料,根据有无高眼压分为观察组和对照组,采用Pearson单因素分析及Logistic回归分析确定玻璃体切割联合眼内填充术后早期高眼压的临床相关危险因素。结果 113例患者中32例出现术后早期高眼压,占28.32%。Pearson单因素分析显示,患者出现高眼压与临床分期、合并视网膜脱离、行晶状体切除术、眼内填充以及激光光凝情况有关(P<0.05);Logistic回归分析显示,合并视网膜剥离、行晶状体切除术以及眼内填充是玻璃体切割联合眼内填充术后早期高眼压的危险因素(P<0.05)。结论玻璃体切割联合眼内填充术后早期出现高眼压的影响因素较多,包括合并视网膜剥离、行晶状体切除术以及眼内填充等。临床上应选择合理的手术方式,并术后积极监测眼压,对症治疗,积极随访,以有效提高玻璃体切除术的成功率,降低术后早期高眼压的发生率,缓解患者的痛苦。

Objective To study the correlated factors and treatment of high intraocular pressure after vitrectomy combined with intraocular tamponade. Method Selected 113 cases to underwent vitrectomy combined with intraocular tamponade in our hospital, and divided into experimental group and control group according to the presence or absence of ocular hypertension. Used single factor analysis of Pearson and logistic regression analysis to determine the clinical risk factors of high intraocular pressure after vitrectomy combined with intraocular tamponade. Result The single factor analysis showed that patients with high intraocular pressure were related with clinical staging, whether complicated retinal detachment, whether treated with lensectomy, whether intraocular tamponade and laser light coagulation （P〈0.05）; logistic regression analysis showed the patients with retinal detachment, treated with lensectomy and intraocular tamponade （P〈0.05） were risk factors of high intraocular pressure after vitrectomy combined with intraocular tamponade. Conclusion There were many factors affecting early intraocular hypertension after vitrectomy combined with intraocular tamponade. The factors associated with retinal detachment, intraocular lens resection and intraocular tamponade were the factors affecting the intraocular pressure. Surgical clinic should choose a reasonable, and actively monitoring postoperative intraocular pressure, symptomatic treatment, active follow-up, vitreous body resection can effectively improve the success rate, reduce the incidence of early high intraocular pressure, relieve the pain of patients.