甲状腺相关眼病手术治疗前后的眼压变化

Comparision ofintraocular pressure before and after surgery for thyroid - associated ophthalmopathy

目的 评估甲状腺相关眼病（Thyroid-associated ophthalmopathy,TAO）患者行眶减压术或斜视矫正术治疗前后眼压的变化.方法 对象为在2008年12月至2009年12月确诊为TAO,并行眶减压或斜视矫正术患者25例（35只眼）,比较患者术前、术后的第一眼位眼压（平视）和第二眼位眼压（上视）.结果 行眶减压术16只眼,术前平均眼压为：第一眼位,（17.86±4.32）mmHg,第二眼位（23.55±7.16）mmHg.术后平均眼压为：第一眼位（14.57±3.86）mmHg,下降18.42%,P＜0.05,第二跟位（18.77±4.83）mmHg,下降20.3%,P＜0.04;行斜视矫正术19只眼,术前平均眼压为：第一眼位,（17.89±3.85）mmHg,第二眼位（23.12±6.98）mmHg,术后平均眼压为：第一眼位（15.85±3.60）mmHg,下降11.4,P＜0.05,第二眼位：（17.88±3.59）mmHg,下降19.17%,P＜0.03,其中术前眼压＞21mmHg诊断为高眼压症和诊断为青光眼的患者术后眼压下降的更加明显.结论 TAO患者行眶减压术或斜视矫正术后眼压均有明显下降.

Objective To evaluate the changes of the intraocular pressure （IOP） in subjects with thyroid-associated ophthalmopathy （TAO） treated with orbital decompression or extraocular muscle surgery.Methods The medical records of patients with TAO who visited in our department and underwent orbital decompression or strabismus surgery from Dec.2008 through Dec.2009 were reviewed and analyzed retrospectively. The IOPs before and after surgery in both primary gaze and upgaze were all measured. Results Of the 16 eyes that underwent orbital decompression, the mean pre-operative IOPs were 17.86± 4.32 mmHg and 23.55± 7.16 mmHg in gaze and upgaze, respectively. The post-operative IOPs were 14.57± 3.86 mmHg and 18.77± 4.83 mmHg in upgaze, respectively. The mean pre-operative IOPs in the 19 eyes that underwent strabismus surgery were 17.89± 3.85mmHg and 23.12± 6.98mmHg in gaze and upgaze, respectively. The post-operative IOPs were 15.85± 3.60 mmHg and 17.88± 3.59 mmHg in gaze and upgaze. In subjects with a pre-operative IOP〉21 mmHg or in treatment for glaucoma we observed a greater reduction in IOP （P〈 0.005）. Conclusions Orbital decompression or extraocular muscle surgery can reduce IOPs in TAO patients significantly.