玻璃体切割术后高眼压影响因素研究进展

Research progress on factors affecting high intraocular pressure after vitrectomy

高眼压是玻璃体切除术后常见的严重并发症之一。患者持续性的眼压升高将对患者术后视力造成不可逆的影响,甚至失明。本综述总结玻璃体切除术后产生高眼压的原因,并对其整理分析。利用中国知网、PubMed、Web of Science中英文数据库,以"玻璃体切割术""高眼压""视网膜""硅油"为关键词,检索2014-06-2018-10相关文献。纳入标准:(1)玻璃体切割术后眼压升高危险因素的临床分析;(2)玻璃体切除联合硅油填充术后高眼压的临床分析;(3)体位与硅油对眼压的影响。剔除标准:(1)年度较久综述类文献;(2)研究资料缺失或质量较差。最终48篇文献纳入分析。结果表明,患者行玻璃体切除术后高眼压的发生分别与其原发病、手术方式、术中眼内填充物、术后炎性反应、术后局部用药及术后体位6个方面有关。明确玻璃切除术后高眼压的发生原因,对高眼压的治疗和预防提供了重要依据,并对挽救术后患者视力具有重要意义。

High intraocular pressure is one of the most common serious complications after vitrectomy.Sustained elevated intraocular pressure in patients will have an irreversible effect on postoperative visual acuity,even blindness.This review will summarize the causes of postoperative high intraocular pressure and analyze them.Using Chinese and English databases including CNKI,PubMed and Web of Science,with the words "vitrex cutting","high intraocular pressure","retina" and "silicone oil" as keywords,related literature were searched from June,2014 to October,2018.Inclusion criteria were:(1)clinical analysis of risk factors for elevated intraocular pressure after vitrectomy;(2)clinical analysis of high intraocular pressure after vitrectomy combined with silicone oil filling;(3)effect of body position and silicone oil intraocular pressure.Exclusion criteria were:(1)longer-term review literature;(2)lack of research data or poor quality.The final48 articles were included in the analysis.The results showed that the occurrence of high intraocular pressure after vitrectomy was influenced by primary disease,surgical procedure,intraoperative intraocular filler,postoperative inflammatory reaction,postoperative local medication,and postoperative position.Defining the cause of high intraocular pressure after vitrectomy will provide an important basis for the treatment and prevention of high intraocular pressure,and make an important contribution to the rescue of postoperative vision.