微创玻璃体切除联合白内障手术术后眼压观察

Observation on postoperative intraocular pressure after microinvasion vitrectomy combined with cataract surgery

目的观察微创玻璃体切除术联合白内障手术术后早期眼压的变化。方法前瞻性病例对照研究。2016年8月至2017年12月收治的玻璃体视网膜疾病伴白内障126例(126眼),随机分为两组。行微创玻璃体切除术联合超声乳化术36例(36眼)为联合组,单纯行玻璃体切除术90例(90眼)为对照组。观察术后7天的眼压。结果联合组术前及术后1、3、7天眼压依次为(12.5±3.2)mmHg、(13.5±3.7)mmHg、(11.6±4.0)mmHg、(10.4±2.9)mmHg(1mmHg=0.133kPa);而对照组依次为(12.6±3.4)mmHg、(13.9±4.2)mmHg、(12.4±3.8)mmHg和(13.1±2.7)mmHg。术后7天联合组眼压低于对照组,差异有统计学意义(t=4.964,P=0.0001);其余时间点两组间差异无统计学意义(P>0.05)。术后7天联合组眼压波动值(3.6±3.1)mmHg低于对照组的(6.2±4.3)mmHg,差异有统计学意义(t=3.298,P=0.0013)。联合组高眼压者占8.3%和低眼压者占5.6%,其发生率均低于对照组的22.2%和26.7%,两组差异均有统计学意义(χ^2=3.8673,4.1022;P=0.0492,0.0428)。结论微创玻璃体切除术联合白内障手术治疗玻璃体视网膜疾病伴白内障有助于稳定术后早期眼压。

Objective To observe the intraocular pressure after microinvasion vitrectomy combined with phacoemulsification. Methods A prospective case-contral study.The data of 126 eyes of 126 cases of vitreoretinal diseases and cataract from Aug. 2016 to Dec. 2017 were divided into two groups randomly. The combined group, 36 eyes of 36 cases, underwent microinvasion vitrectomy combined with phacoemulsification and intraocular lens implantation. The control group, 90 eyes of 90 cases, underwent simple microinvasion vitrectomy. The intraocular pressure at 7 days after operation was observed and compared between the two groups. Results The intraocular pressure of the combined group were (12.5±3.2) mmHg,(13.5±3.7) mmHg,(11.6±4.0) mmHg,(10.4±2.9) mmHg(1 mmHg=0.133 kPa) before and 1, 3 and 7 days after operation, that of the control group was (12.6±3.4) mmHg,(13.9±4.2) mmHg,(12.4±3.8) mmHg and (13.1±2.7) mmHg, respectively. The intraocular pressure of combined group at 7 days after operation was lower than that of control group, the difference was statistically significant (t=4.964, P=0.0001), and the difference was not significant in other time points between the two groups (P>0.05). The intraocular pressure fluctuation in combined group at 7 days after operation was lower than that in the control group, the difference was statistically significant (t=3.298, P=0.0013). The incidence of intraocular hypertension (8.3%) and the incidence of introcular hypotension (5.6%) in combined group were lower than those in the control group (22.2%, 26.7%). The difference were statistically significant (χ^2=4.1022, 3.8673, P=0.0428, 0.0492). Conclusion Microinvasion vitrectomy combined with cataract surgery is helpful to stabilize intraocular pressure in patients with vitreoretinal diseases and cataract.