高度近视与白内障超声乳化吸除人工晶状体植入术后眼压变化相关性的研究

Study of the role of high myopia in intraocular pressure changes in patients with phacoemulsification plus IOL implantation

目的研究高度近视对白内障超声乳化吸除人工晶状体植入术后眼压的影响。方法超声乳化白内障吸除人工晶状体植入手术的住院患者120例(150只眼),排除有明显影响眼压各种因素,按眼轴长度分为高度近视(HM)组、低度近视(LM)组、非近视(NM)组。术前及术后24、48、72、96、120 h进行眼压测量。并进行两因素方差分析,t检验。结果 3组间(P<0.001)及不同时间点间(P<0.001)平均眼压差别均有高度统计学意义。术前、术后各时间点,HM组平均眼压均高于LM组和NM组,术后24 h眼压升高率为54.16%,明显高于LM组的28%和NM组的22.58%(P<0.001)差别有高度统计学意义。结论高度近视是导致白内障超声乳化吸除人工晶状体植入术后眼压升高的重要因素,这种影响与近视程度正相关;对于有近视的白内障患者进行超声乳化手术前后须评价其眼压,术后眼压升高特别是眼压≥30 mm Hg或眼压持续升高48 h以上者,待手术恢复后应作青光眼排查。

Objective To study the role of high myopia in intraocular pressure（IOP） changes in patients with phacoemulsification plus IOL implantation.Methods 120 patients（150 eyes） with normal IOP were included and divided into three groups according to their axial lengths： high myopia（HM）,low myopia（LM）,and non-myopia（NM） groups.IOPs were measured before and after operation at 24,48,72,96,and 120 hours respectively.Analysis of variance and t-test were used as statistical evaluation.Results While there were significant differences in mean IOP among three groups and all time points（P〈0.001）,mean IOP in HM group was higher than that in LM and NM groups.At 24 hrs after surgery,mean IOP increased by 54.16%,28%,22.58% in HM,LM and NM groups respectively（P〈0.001）.Conclusions High myopia might play an important role in IOP elevation after phacoemulsification.Attention should be paid to evaluate IOP in myopia patients before and after phacoemulsification and repeated measurements also should be taken to in the patients whose IOP is above 30 mmHg or slightly higher than normal but lasts more than 48 hours.