玻璃体腔注射曲安奈德术后继发性青光眼的发生率和危险因素分析

Analysis of incidence rate and risk factors of secondary glaucoma after intravitreal injection of triamcinolone acetonide

目的:分析玻璃体腔注射曲安奈德术后继发性青光眼的发生率和危险因素。方法:对连续收治的256例有玻璃体腔注射曲安奈德适应证的各类眼底病患者实施单次玻璃腔注射4mg/0.1mL曲安奈德手术,观察其术后眼压变化情况。主要适应证包括湿性年龄相关性黄斑变性,其它原因如糖尿病性视网膜病变、视网膜中央静脉阻塞、视网膜分支静脉阻塞,视网膜静脉周围炎等引起的黄斑水肿性疾病。结果:256例256眼经至少3mo的追踪观察随访中,56眼发生继发性青光眼,发病率为21.9%。结论:继发性青光眼与年龄、性别、血压、糖尿病、玻璃体腔注药术的不同适应证、术前是否行白内障手术、是否行光动力治疗、是否行玻璃体切除手术等因素没有相关性。注药前青光眼病史的存在和基础眼压高于19mmHg等情况为术后继发性青光眼的显著危险因素。

AIM： To analyze the incidence rate and risk factors of secondary glaucoma after intravitreal injection of triamcinolone acetonide. METHODS： Two hundred and fifty-six cases with the indication of triamcinolone acetonide were treated with intravitreal injection of triamcinolone acetonide 4mg/0. l mL, and postoperative intraocular pressure changes were observed. Main indications included wet age-related macular degeneration, and macular edema disease caused by other reasons, such as diabetic retinopathy, central retinal vein occlusion, branch retinal vein occlusion, retinal periphlebitis. RESULTS： Among the 256 patients（256 eyes） who were followed up for at least 3 months, secondary glaucoma occurred in 56 eyes, and the incidence rate was 21. 9%. CONCLUSION： Secondary glaucoma does seem to be not correlated with age, sex, blood pressure, diabetes, and different indications of drug infusion into vitreous cavity, whether the patient underwent preoperative cataract surgery, photodynamic therapy or vitrectomy. The history of glaucoma before drug injection and basic intraocular pressure above 19mmHg are significant risk factors for secondary glaucoma.