玻璃体切割术中曲安奈德留存对术后眼压和视网膜厚度的影响

Clinical study of intraocular pressure and retinal thickness affected by residual triamcinolone acetonide after vitrectomy

目的:分析玻璃体切割术中曲安奈德(triamcinolone acetonide,TA)留存对患者术后眼压和视网膜厚度的影响。方法:回顾性研究。回顾分析2016-10/2017-10在我科行玻璃体切割手术治疗的83例83眼患者的病历资料,患者术中均使用TA作为玻璃体染色剂且未行硅油或气体填充,手术结束时其中32眼患者玻璃体腔内可见TA白色粉末残留(残留组), 51眼患者未见TA白色粉末残留(无残留组)。比较两组患者术后1wk,3mo时的眼压和黄斑中心凹厚度(central macular thickness,CMT)情况。结果:两组患者间术前平均眼压比较,差异无统计学意义(t=0. 56,P> 0. 05);术后1wk平均眼压无残留组为15. 48±3.8mmHg,残留组为20.09±6.14mmHg,残留组高于无残留组,差异有统计学意义(t=3.81,P<0.05);术后3mo平均眼压无残留组为13.75±2.35mmHg,残留组为16.26±2.52mmHg,残留组高于无残留组,差异有统计学意义(t=4.54,P<0.05)。术后1wk无残留组平均CMT为240.57±42.69μm,残留组平均CMT为215.03±18.38μm,残留组低于无残留组,差异有统计学意义(t=3.75,P<0. 05);无残留组与残留组术后3mo平均CMT比较,差异无统计学意义(t=0.21,P>0.05)。结论:玻璃体切割术中作为染色剂的TA颗粒留存可使术后眼压短期内有升高风险。

AIM： To study the effect of residual triamcinolone acetonide（ TA） to intraocular pressure（ IOP） and retinal thickness in patients after vitrectomy.METHODS： Retrospective study. The medical data of 83 patients（ 83 eyes） after vitrectomy in our hospital from October 2016 to October 2017 were analyzed retrospectively. The 83 patients were treated with TA as vitreous dyeing. Vitreous cavity was not filled with silicone oil or gas. Totally 32 eyes were observed that triamcinolone acetonide was residual in vitreous cavity,51 eyes were not observed the residual,and after 1 wk and3 mo,intraocular pressure and macular center concave thickness（ CMT） of two groups was compared. RESULTS： There was no statistical difference in preoperative average intraocular pressure between two groups（ t = 0.56,P0.05）. After 1 wk,IOP of no residual group was 15.48±3.8 mmhg,IOP of residual Group was 20.09±6.14 mmhg. IOP of residual group were higher than IOP of no residual group, the difference was statistically significant（ t = 3. 81,P 0. 05）. After 3 mo,postoperative average IOP was 13.75±2.35 mmhg,IOP of residual Group was 16.26±2.52 mmhg,IOP of residual group was higher than IOP of no residual group, the difference was statistically significant（ t = 4.54,P 0.05）. After 1 wk,the average CMT of no residue group was 240.57± 42.69μm,that of residual group was 215.03±18.38,and the difference was statistically significant（ t = 3.75,P0.05）. After 3 mo,there was no statistical significance on the average CMT between no residual group and residual group（ t = 0.21,P0.05）.CONCLUSION： The residual triamcinolone acetonide as a dyeing agent during vitrectomy may raise the risk of postoperative intraocular pressure in short term,and after3 mo without any significant effect on the thickness of macular center.