硅油填充眼术后高眼压的物理因素分析

Physical factors for ocular hypertension following pars plana vitrectomy and silicone oil injection

目的分析硅油填充眼术后发生高眼压的相关因素,探讨物理因素对眼压升高的影响。方法回顾性分析222例(226只眼)患者行玻璃体切除并硅油填充术的病例资料,根据屈光状态、疾病种类和手术月份进行分组,研究各组的术后眼压情况与这些因素的关系。结果患者术后高眼压总发生率为30.1%。不同屈光状态组术后高眼压发生率分别为:22.2%(<-6.00 D组),37.5%(-6.00^-10.00 D组)和53.7%(>-10.00 D组),3组间差异有统计学意义(P<0.001)。视网膜脱离组高眼压发生率(39.0%)显著高于糖尿病视网膜病变组(22.9%)、玻璃体积血组(15.0%)和其他疾病组(20.0%)(P=0.01)。不同月份间高眼压发生率差异有统计学意义(P=0.002),10月至次年2月的高眼压发生率高于其他月份。结论高度近视患者术后高眼压发生率显著升高,视网膜脱离患者术后高眼压发生率明显高于其他疾病患者,眼内与环境温差较大导致硅油体积增加也是术后发生高眼压的重要因素之一。

Objective To investigate the related factors,especially the physical factors for ocular hypertension(OHT)following pars plana vitrectomy(PPV)and silicone oil injection.Methods Clinical data of 226 eyes of 222 cases treated with pars plana vitrectomy(PPV)and silicone oil tamponade were retrospectively analyzed.Subjects were divided into groups according to refractive status,disease types and month of operation,respectively.The relationship between postoperative intraocular pressure(IOP)and these factors was studied.Results 30.1%of the eyes treated with PPV and silicone oil tamponade showed high IOP.The incidence of OHT was 22.2%,37.5%and 53.7%in group A,B and C(A:<-6.00 D,B:-6.00 D to-10.00 D and C:>-10.00 D),respectively.Significant difference was observed among these three groups(P<0.001).The incidence of OHT was significantly higher in retinal detachment group(39.0%)than that in diabetic retinopathy group(22.9%),vitreous hemorrhage group(15.0%)and other diseases group(20.0%)(P=0.01).The IOP from October to February was higher than that of other months and the incidence of OHT for different months was statistically different(P=0.002).Conclusions The incidence of OHT was more common among patients with high myopia or retinal detachment.The change of silicone oil volume along with temperature was one of the most important factors for the occurrence of OHT following PPV and silicone oil tamponade.