高度近视眼硅油填充术后短期内眼压变化

Changes of IOP at the short time after silicone oil temponade in high myopic eyes

目的观察高度近视眼硅油填充术后短期内眼压变化,并探讨其眼压升高的原因及处理方法。方法2006年2月至2007年10月行硅油填充术后的82例95眼患者,分为高度近视眼组37例(40眼)与非高度近视眼组45例(55眼);高度近视眼组屈光度数为6.5～16.5D,平均12.5D,非高度近视组眼屈光度数为0.5～4.5D,平均2.5D;分别观察术后1d、1周、1个月、2个月、3个月的眼压,并对2组高眼压累积发生率进行比较,分析高度近视眼硅油填充术后短期内高眼压的发生原因及处理方法。结果术后1d、1周、1个月、2个月和3个月高度近视眼组高眼压累积发生率分别为20.00%(8眼)、25.00%(10眼)、27.50%(11眼)、30.00%(12眼)、35.00%(14眼);非高度近视眼组高眼压累积发生率分别为5.45%(3眼)、9.09%(5眼)、10.91%(6眼)、10.91%(6眼)、14.55%(8眼)。2组术后1d、1周、1个月、2个月、3个月高眼压累积发生率差异均有统计学意义(均为P<0.05)。高度近视眼组高眼压发生率明显高于非高度近视眼组,大部分患眼经药物或取出少量硅油后眼压可以得到控制,少部分患眼需短期内取出硅油来控制眼压。结论高度近视眼行硅油填充术后容易出现高眼压,经药物和(或)手术治疗眼压可得到有效的控制。

Objective To investigate the changes of intraocular pressure（IOP） at the short time after silicone oil temponade in high myopic eyes and to explore the causes and treatment of high IOP.Methods A total of 82 cases（95 eyes）,underwent silicone oil temponade from February 2006 to October 2007,were devided into high myopic group（37 cases,40 eyes） and non-high myopic group（45 cases,55 eyes）.Diopters of high myopic group were 6.5 D to 16.5 D,averaged in 12.5 D;Diopters of non-high myopic group were 0.5 D to 4.5 D,averaged in 2.5 D.IOP was observed at postoperative 1 day,1 week,1 month,2 months and 3 months,respectively.Accumulative incidences of high IOP were compared between the two groups.The causes and treatment of high IOP at the short time after silicone oil temponade were analyzed in high myopic eyes.Results The accumulative incidences of high IOP were 20.00%（8 eyes）,25.00%（10 eyes）,27.50%（11 eyes）,30.00%（12 eyes） and 35.00%（14 eyes） at postoperative 1 day,1 week,1 month,2 months and 3months,respectively,in high myopic group,were 5.45%（3 eyes）,9.09%（5 eyes）,10.91%（6 eyes）,10.91%（6 eyes） and 14.55%（8 eyes）,respectively,in non-high myopic group.There was significant difference in accumulative incidence of high IOP between the two groups at postoperative 1 day,1 week,1 month,2 months and 3 months（all P〈0.05）.In high myopic group,the incidence of high IOP was obviously higher than that in non-high myopic group,IOP of most patients could be controlled with drug treatment or removing a little silicone oil,and few patients needed to take out silicone oil at the short time to control IOP.Conclusion High IOP is easily happened in high myopic eyes after silicone oil temponade,but can be effectively controlled with drug treatment or surgery.