预置前房穿刺在玻璃体切除手术中的应用

Using preset anterior chamber puncture in the vitrectomy

目的探讨预置前房穿刺在玻璃体切除手术中的应用。方法对187例187眼玻璃体视网膜疾病行玻璃体切除手术,在玻璃体切除手术结束时行预置前房穿刺,以备患者手术后发生高眼压时在裂隙灯显微镜下直接在前房穿刺口位置放液降眼压。结果187例187眼玻璃体切除手术后发生高眼压者28眼,轻度高眼压者(24~29mmHg)8例应用降眼压药物后眼压降至正常,中度以上高眼压者(>30mmHg)20例实施前房放液后眼压降至正常者16例,多次放液眼压不降实施虹膜激光打孔后眼压降至正常者4例。无一例发生前房穿刺相关并发症。结论通过预置前房穿刺口放液降眼压是处理玻璃体切除手术后发生高眼压简便、安全、有效的一种方法。

Objective To discuss the application of anterior chamber puncture in the vitrectomy.Methods A total of 187 patients(187 eyes)with vitreoretinal diseases were included in this study.The anterior chamber puncture was applied on these 187 patients during the vitrectomy so that we could drain the aqueous humor from the puncture when the high intraocular pressure(IOP)occurred after surgery.Results Postoperative IOP elevation occurred in 28 eyes.The IOP of 8 eyes were mildly increased(24~29 mmHg),which could be controlled by IOP-lowering drugs.The IOP of 20 eyes were moderately or seriously increased(>30 mmHg),16 eyes’IOP of which could be controlled by draining the aqueous humor from the puncture and there were still 4 eyes’IOP couldn’t be controlled by this way.Laser iridectomy was used for these 4 eyes and The IOP returned to normal.None of these 187 patients got any complications because of anterior chamber puncture.Conclusions Anterior chamber puncture is a simple,safe and effective way to control IOP elevation after vitrectomy.