玻璃体切割联合白内障超声乳化术后高眼压临床观察

Clinical observation of ocular hypertension after pars plana vitrectomy combined with phacoemulsification

目的探讨玻璃体切割联合白内障超声乳化术(PPV+Phaco)术后高眼压的发生率和危险因素。方法对83例(85只眼)行PPV+Phaco联合手术患者的临床资料进行回顾性分析,高眼压的诊断标准为非接触式眼压计眼压≥25 mmHg。结果85只眼中有27只眼术后发生高眼压,发生率31.8%。大多数术后高眼压发生在术后3 d内(22只眼,占81.5%)。27只眼中23只眼高眼压在1周内得以缓解。增生性糖尿病视网膜病变患眼术后高眼压发生率为50%,与其他疾病高眼压发生率比较,差别有显著性(x^2=4.303,P=0.038);术中联合巩膜外环扎、联合硅油充填、联合弥漫视网膜光凝及未植入IOL眼术后高眼压的发生率,分别与未联合巩膜外环扎、未联合硅油填充、未联合弥漫视网膜光凝及植入IOL眼术后高眼压发生率比较,差别有显著性(P<0.05)。结论术后高眼压是PPV+Phaco联合手术常见并发症,发生率主要与原发病的种类及联合术式相关。

Objective To investigate the intraocular pressure （lOP） elevation in patients who have undergone pars plana vitrectomy （ PPV ） combined with phacoemulsification. Method 83 patients （ 85 eyes ） who underwent PPV combined with phacoemulsification were reviewed. Ocular hypertension was defined as lOP 25mmHg or more by non -touch tonometry examination. Results Twenty-seven eyes presented ocular hypertension after operation （ 31.8 % ） . Among them the lOP occurred mostly within 3 days （22eyes, 81.5% ）. In 23 cases （23 eyes） lOP returned to normal in lweek after treatment. The patients suffered from the PDR were more likely to have lOP elevation than other patients in our study （ 50%, P 〈 0. 05 ）. Placement of a scleral buckle, use of silicone oil injection, scatters endophotocoagulation intraoperatively and without intraocular lens implantation was related to the postvitrectomy lOP elevation （ P 〈 0.05 ）. Conclusion lOP elevation was a common complication of PPV combined with phacoemulsification. The incidence of ocular hypertension was related to certain primary eye diseases and combined ocular procedures.