超声乳化术后高眼压的原因分析

An analysis of the cause of high intraocular pressure after phacoemulsification

目的分析超声乳化术后眼压升高的原因.方法本研究为回顾性病例研究.收集郴州市第一人民医院2017年6月至2019年6月超声乳化人工晶状体植入手术2211例(2860眼)的临床资料,分析术后高眼压的原因.结果术后高眼压127眼(4.44%);其中老年性白内障术后高眼压发生率为1.74%(32/1836),葡萄膜炎并发白内障发生率为10.00%(11/110),糖尿病患者白内障发生率为11.92%(62/520),外伤性白内障发生率为7.93%(10/126).高眼压发生原因:黏弹剂残留42眼(33.07%),炎症反应39眼(30.71%),后囊破裂、皮质残留15眼(11.81%),玻璃体脱出10眼(7.87%),前房积血5眼(3.94%),皮质类固醇性青光眼4眼(3.15%),人工晶状体嵌顿、移位、脱位3眼(2.36%),晶状体核坠入玻璃体3眼(2.36%),新生血管性青光眼2眼(1.57%),囊袋阻滞综合征1眼(0.79%),其它原因3眼(2.36%).根据术后高眼压的原因进行相应处理.结论黏弹剂残留和炎症反应是引起超声乳化术后高眼压的主要原因.合并有糖尿病、陈旧性葡萄膜炎及眼外伤患者比单纯性老年性白内障患者容易出现术后高眼压.

Objective To analyze the cause of high intraocular pressure(IOP)after phacoemulsification.Methods This was a retrospective case study.The clinical data of 2860 eyes of 2211 patients who underwent phacoemulsification and intraocular lens implantation from Jun.2017 to Jun.2019 in the People’s Hospital of Chenzhou District were collected.The causes of high IOP after operation were analyzed.Results After surgery,high IOP occurred in 127 eyes(4.44%).The incidence of high IOP was 1.74%(32/1836)in senile cataract,10.00%(11/110)in uveitis with cataract,11.92%(62/520)in diabetes with cataract and 7.93%(10/126)in traumatic cataract.The causes of high IOP included 42 eyes of viscoelastic residue(33.07%),39 eyes of inflammatory reaction(30.71%),15 eyes of rupture of posterior capsule and cortex residue(11.81%),10 eyes of vitreous prolapse(7.87%),5 eyes of hyphema(3.94%),4 eyes of corticosteroid glaucoma(3.15%),3 eyes of incarceration,displacement and dislocation of intraocular lens(2.36%),3 eyes of the lens nucleus into the vitreous cavity(2.36%),2 eyes of neovascular glaucoma(1.57%),1 eye of capsular block syndrome(0.97%)and 3 eyes of other reasons(2.36%).According to the causes of postoperative high intraocular pressure,the coresponding treatment was performed.Conclusion Viscoelastic residue and inflammatory reaction are the main causes of high IOP after phacoemulsification.Cataract with diabetes mellitus,uveitis and ocular trauma are more likely to have high IOP after phacoemulsification than senile cataract.