白内障超声乳化吸除术后高眼压不同治疗方法的临床研究

The clinical study about different treatment in elevated intraocular pressure after phacoemulsification

目的探讨治疗白内障超声乳化吸除手术后早期眼压升高的不同治疗方法。方法在住院的年龄相关性白内障患者中选择超声乳化吸除手术的连续性病人513例602眼，将术后出现高眼压的62例71眼随机分为放液组和药物组，术前常规测量眼压，术后4-6h测眼压，眼压高者根据分组采用角膜缘切口放液和药物控制眼压，并观察术后1d、2d、3d、1周的眼压变化。将资料进行t检验和r检验。结果放液组和药物组术前眼压和4～6h后眼压比较差别无统计学意义，术后1d和2d，两组比较差别有统计学意义，放液组眼压低于药物组（P=0.000），3d和1周则两组无统计学差异（P=0.451.P=0.791）。术后1d、2d放液组眼压升高的病例少于药物组（P=0.000，P=0.011）。术后3d两组都没有高眼压病例出现。结论药物治疗超声乳化后高眼压起效慢，需要的时间长，而辅助切口放液简便、安全、有效，是处理早期高眼压的好方法。

Objective To study the Therapy in treating early elevated intraocular pressure （ IOP） after phacoemulsification. Methods Total consecutive 513 patients （ 602 eyes） to be in hospital underwent cataract phacoemulsification were studied. 62 patients （ 71 eyes） with high intraocular pressure were randomized divided into 2 groups： adjunctive limbus corneae incision tapping（ 36 eyes） and drug treatment（ 35 eyes）. The IOP was measured preoperatively and postoperatively 4-6 h. Two methods were used according to groups, and IOP changes were observed in postoperatively 1 d,2 d ,3 d and 1 w. The data was analyzed by t and）（2 test. Results There was no difference in incision tapping and drug treatment group preoperatively and postoperatively 4 -6 h and the difference was confirmed after ld and 2d,the IOP of incision tapping group was low（ P =0. 000） ,but not in 3 d and 1 w（ P = 0. 451 ,P =0. 791 ）. The increased IOP eyes in incision tapping group were not so many as in drug treatment group （ P = 0. 000 ,P = 0. 011） , and there were no analogous eyes in two groups after 3 d. Conclusion Drug treatment in elevated intraocular pressure after phacoemulsification was low effective. Tapping from adjunctive limbus corneae incision was simple, safe and effective to decrease early IOP after surgery.