白内障超声乳化IOL植入术后早期高眼压的临床分析

Clinical analysis of early high intraocular pressure after intraocular lens implantation in phacoemulsification

目的:探讨白内障超声乳化人工晶状体植入术后早期高眼压(IOP)发生的相关因素及应对措施。方法:对我院2014-01/2016-01完成的白内障超声乳化人工晶状体植入术658例726眼临床资料进行回顾分析。结果:术后发生高眼压共38眼,发生率为5.2%。术后眼压升高的幅度为21~55mmHg,大多数患者出现高眼压的时间为术后6~24h。其中主要的相关因素:前房黏弹剂残留24眼(63.2%),葡萄膜炎9眼(23.7%),前房积血2眼(5.3%),皮质残留2眼(5.3%),囊袋阻滞综合征1眼(2.6%)。应用降眼压药物,抗炎治疗联合前房放液,术后3d均能有效控制眼压≤21mmHg,其中囊袋阻滞综合征1眼联合YAG激光治疗。结论:黏弹剂残留和炎症反应是引起术后高眼压的主要原因。术前评估,提高手术技巧,术后及时发现和正确处理,能有效防止术后高眼压,促进视功能的恢复。

AIM： To investigate the related factors and solutions of early high intraocular pressure（IOP）after intraocular lens（IOL）implantation in cataract phacoemulsification. METHODS：This retrospective cases series collected 658 patients（726 eyes）after IOL implantation in cataract phacoemulsification from Jan.2014 to Jan.2016 in the Second People＇s Hospital of Beihai. RESULTS：High postoperative IOP happened in 38 eyes（5.2%）, and the range was from 21mmHg to 55mmHg. Most of them happened between 6h to 24h after surgery. The main causes of high IOP were 24 eyes of viscoelastic residue（63.2%）, 9 eyes of uveitis（23.7%）, 2 eyes of hyphema（5.3%）, 2 eyes of residual cortex（5.3%）and 1 eye of pouch blockage syndrome（2.6%）. All cases were controlled under 21mmHg after 3d treating with drugs, anti-inflammatory and anterior chamber tapping. YAG laser therapy was performed in 1 eye of pouch blockage syndrome.CONCLUSION： Viscoelastic residue and inflammation were the main causes of high postoperative IOP in phacoemulsification. With comprehensive preoperative evaluation, surgical skills improvement and effective response, the high postoperative IOP would be effectively prevented as well as the recovery of visual acuity.