玻璃体切割术后角膜上皮病变的危险因素分析

Analysis of risk factors for corneal epithelial lesions after vitrectomy

目的 探究玻璃体切割术后角膜上皮病变的危险因素。方法 40例实施玻璃体切割术的患者为研究对象,统计玻璃体切割术后角膜上皮病变发生率,分析玻璃体切割术后角膜上皮病变的影响因素。结果 40例实施玻璃体切割术的患者,术后发生角膜上皮病变10例,发生率为25.00%。针对角膜上皮病变患者进行针对性干预, 9例患者治疗7~14 d完全好转,仅有1例患者形成角膜云翳。Logistic单因素分析结果显示,年龄>65岁、糖尿病、手术时间长、联合白内障超声乳化术、术中硅油填充、术后高压眼是玻璃体切割术后角膜上皮病变的影响因素(P<0.05)。Logistic多因素分析显示:年龄>65岁、糖尿病、手术时间长、术中硅油填充、术后高压眼是玻璃体切割术后角膜上皮病变的独立危险因素(OR=1.271、18.598、1.110、4.657、10.801, P<0.05)。结论 玻璃体切割术后角膜上皮病变的危险因素较多,围手术期需做好多方面防控,针对已发生角膜上皮病变的患者及时进行干预,从而确保预后。

Objective To investigate the risk factors for corneal epithelial lesions after vitrectomy.Methods 40 patients who underwent vitrectomy were selected as the research subjects. The incidence of corneal epithelial lesions after vitrectomy was counted, and the influencing factors of corneal epithelial lesions after vitrectomy were analyzed. Results Of the 40 patients who underwent vitrectomy, 10 patients had corneal epithelial lesions after surgery, with an incidence rate of 25.00%. Targeted intervention was carried out for patients with corneal epithelial lesions, 9 patients were completely improved after 7-14 d of treatment, and only 1 patient developed corneal nebual. Logistic univariate analysis showed that age>65 years, diabetes mellitus, long operation time, combined cataract phacoemulsification, intraoperative silicone oil filling, postoperative high intraocular pressure were the influencing factors of corneal epithelial lesions after vitrectomy(P<0.05). Logistic multivariate analysis showed that age>65 years, diabetes mellitus, long operation time, intraoperative silicone oil filling, and postoperative high intraocular pressure were independent risk factors for corneal epithelial lesions after vitrectomy(OR=1.271, 18.598, 1.110, 4.657, 10.801;P<0.05). Conclusion There are many risk factors for corneal epithelial lesions after vitrectomy, and various prevention and control should be done during the perioperative period, and timely intervention should be carried out for patients with corneal epithelial lesions to ensure the prognosis.