眼球穿通伤玻璃体切除术后低眼压的临床分析

Clinical analysis of ocular hypotension after vitrectomy in penetrating injury of eyeball

目的:探讨眼球穿通伤玻璃体切除术后,低眼压的发生率和危险因素。方法:对64例70眼因眼球穿通伤而行玻璃体切除术的临床资料进行回顾性分析,低眼压的诊断标准为眼压<5mmHg,并随访时间>6mo。结果:64例70眼因眼球穿通伤而行玻璃体切除术后发生低眼压14眼(20%);其中术前有眼内炎和无眼内炎眼术后低眼压发生率分别为40%和9%,两组之间比较差异有显著性意义(χ2=9.73,P<0.05);行视网膜切开术和未行视网膜切开术后低眼压者发生率分别为58%和12%,两组比较差异有显著性意义(χ2=10.57,P<0.05);前部增生性玻璃体视网膜病变者和无前部增生性玻璃体视网膜病变者术后低眼压者发生率分别为50%和14%,两组比较差异有显著性意义(χ2=6.04,P<0.05)。结论:低眼压是眼球穿通伤玻璃体切除术后的一个并发症,术前有眼内炎,术中行视网膜切开以及严重的前部增生性玻璃体视网膜病变是发生低眼压的危险因素。

AIM： To explore the incidence rate and risk factors of ocular hypotension after vitrectomy in penetrating injury of eyeball. METHODS： The medical records of 64 patients with penetrating injury of eyeball who underwent vitrectomy were analyzed retrospectively. Ocular hypotension was defined as a persistent intraocular pressure （lOP） less than 5mmHg for 6 months. RESULTS： Among this 64 patients, ocular hypotension occurred in 14 （20%） in the follow-up. The rate of ocular hypotension in the patients with endophthalmitis was 40%, and 9% in no-endophthalmitis, The difference was statistically significant （X2 = 9.73, P 〈 0.05）. The rate of ocular hypotension in the patients with retinal splitting was 58%,and 12% in no-retinal splitting . The difference was statistically significant （X^2 = 10.57, P〈 0.05）. The rate of hypotony in the anterior proliferative vitreoretinopathy was 50% and 14% in no-anterior proliferative vitreoretinopathy. The difference was statistically significant （X^2 = 6. O4,P〈 0.05）. CONCLUSION： Intraocular hypotony is a complication of vitretomy. The postoperative risk factors of hypotony may include endophthalmitis, retinal splitting , anterior proliferative vitreoretinopathy.