白内障术后早期眼压变化及相关影响因素分析

Short-term change in intraocular pressure and analysis of the related factors after phacoemulsification

目的探讨影响晶状体超声乳化吸出术后早期眼压变化的相关因素及临床意义。方法120例(136眼)行晶状体超声乳化吸出联合人工晶状体植入术,测量术前、术后24h和72h的眼压,比较不同麻醉方式(表面麻醉、球后浸润麻醉)、不同手术切口(巩膜切口、透明角膜切口)、术后口服皮质类固醇与否对术后早期眼压变化的影响。结果术后24h眼压较术前高,72h基本达到术前或略低于术前眼压。晶状体超声乳化术的麻醉方式和术后是否使用皮质类固醇与术后早期眼压变化具有相关性,相关系数分别为0.187和0.280(P<0.014和P<0.001)。球后浸润麻醉的术后眼压较表面麻醉的眼压相对增高;术后不用皮质类固醇比用皮质类固醇眼压相对增高。不同手术切口对术后早期眼压变化则无相关性。结论表面麻醉和术后口服皮质类固醇对白内障超声乳化术后早期眼压的影响较小。

Objective To discuss the clinical importance of related factors affecting intraocular pressure （IOP）after phacoemulsification. Methods In this prospecive study,the IOP in 136 eyes of 120 patients（55 eyes of men,g1 eyes of women,mean age 71.06 years ＋ 12.18 [ SD ] ）was assessed by noncontactable tonometry preoperation,24 and 72 hours after phacoemulsification. The type of anesthesia（ topical versus parabuibar）and the location of incision （ scleral versus corneal） and the application of corticosteroid （ yes versus no）were compared. Statistical analysis was performed using SPSS 2.0 for windows, and P 〈 0. 05 was considered statistically significant. Results The IOP was higher at 24 hours after operations. It retruned to the preoperative level or was a little lower at 72 hours after operations. The type of anesthesia and the early change in lOP after phaeoemulsification had correlation and the value of R was 0.187, P 〈 0. 014;the application of corticosteroid and the early change in IOP after phacoemulsification also had correlation and the valur of R was 0. 280, P 〈 0. 001. The lOP after operation was relatively higher in all eyes in which topical anesthesia or eorticosteroid was used. Conclusion The parabulbar anesthesia and application of eorticosteroid had little effect on postoperative lOP. The type of the lacation of incision hadn＇t correlation.