玻璃体手术后高眼压及其处理

High intraocular pressure after vitreous surgery and its treatment

目的探讨单纯玻璃体切割术及玻璃体切割硅油填充术后高眼压的发生率及处理方法。方法收集2008年1月至2011年1月于我院行玻璃体切割手术或玻璃体切割硅油填充术患者共217例(221眼),对其术后高压发生率、发生时间、房角情况、处理方法及治疗效果进行分析。结果单纯玻璃体切割术后高眼压发生率(2.9%)较玻璃体切割硅油填充术后高眼压发生率(23.5%)低,差异有显著统计学意义(P<0.01)。单纯玻璃体切割术后高眼压均发生于1周以内,玻璃体切割硅油填充术后高眼压发生于1周内者占75.0%,1～4周者占19.4%,12个月以上者占5.6%。术后高眼压药物治疗有效率达78.9%,其中单纯玻璃体切割术后高眼压均可药物控制,玻璃体切割硅油填充术后高眼压药物难以控制者需行手术治疗。结论玻璃体手术后高眼压为常见并发症,药物和手术治疗可以有效控制眼压。早期预防,及时发现并正确处理会减少对视功能的损害。

Objective To study the incidence and treatment of high intraocular pressure after single vitrectomy or vitrectomy with silicon oil implantation. Methods A total of 217 patients（221 eyes） with high intraocular pressure after single vitrectomy or vitrectomy with silicone oil implantation from January,2008 to January, 2011 were collected, and the incidence, time, chamber angle, treatment and its effect of high in- traocular pressure were reviewed and analyzed. Results The incidence of high in- traocular pressure after single vitrectomy（2.9% ） was lower than that after vitrectomy with silicone oil implantation （ 23.5 % ）, there was significant difference （P 〈 0.01 ）. High intraocular pressure after single vitrectomy occurred within 1 week, and after vitrectomy with silicone oil implantation, 75.0% of high intraocular pressure occurred within 1 week,19.4% was from 1 week to 4 weeks,and 5.5% was more than 12 months. Medications effectiveness achieved 78.9% ,in which high intraocular pressure after vitrecto- my could simply through drug control, but that after vitrectomy with silicone oil implan- tation drugs were difficult to control and operation treatment needed. Conclusion High intraocular pressure is a common complication after vitrectomy, medical and surgi- cal treatment can be effectively controlled intraocular pressure. Early prevention, timely detection and proper treatment will reduce the damage of visual function.