摘要
目的探讨超声乳化人工晶体植入术联合玻璃体切除术（PPV）对患者眼内压动态变化的影响。方法选择需行PPV治疗患者70例（73眼）为研究对象。按照手术实施情况分为对照组（33例，35眼）和治疗组（37例，38眼）。对照组仅给予常规PPV治疗，治疗组在PPV治疗的基础上行超声乳化人工晶体植入术。观察术后第1、2、3天，第1、3周及第1、2、3个月患者术眼的眼内压的动态变化情况。结果对照组患者术眼的眼内压在术后第1天达高峰，由术前的（13．74±2．2）mmHg（1mmHg=0．133kPa）升高至（18．5±6．9）mmHg，并于术后第3天回落至术前水平。治疗组患者术眼的眼内压也在术后第1天达高峰，由术前的（12．9±2．4）mmHg升高至（23．44±8．0）mmHg，但直至术后第3周才基本恢复至术前水平。治疗组患者术后第1天术眼的眼内压升高水平较对照组更加明显（P〈0．05）。相关性分析显示：糖尿病视网膜病变及联合超声乳化人工晶体植入术是影响PPV术后第1天术眼眼内压激增（眼内压增加≥10mmHg）的独立危险因素。结论超声乳化人工晶体植入术增加了PPV术后早期眼内压一过性增高的风险，故临床上对眼内压波动敏感的患者使用该术式时应严格把握手术指征。
Objective To investigate the effect of phacoemulsification and intraocular lens implantation combined with vitrectomy on the dynamic changes of intraocular pressure. Methods A sample of 73 eyes of 70 patients was divided into two groups according to the operation method. Phacoemulsification and intraocular lens combined with vitrectomy implantation performed on 38 eyes of 37 patients （study group） were compared with vitrectomy alone performed on 35 eyes of 33 patients （control group）. The dynamic changes of intraocular pressure 1,2,3 days, 1,3 weeks, 1,2,3 months after surgery were observed. Results The intraocular pressure was peaked on the 1st day after surgery in control group from （ 13.7 ± 2.2 ） mm Hg （ 1 mm Hg = 0.133 kPa） preoperatively to （ 18.5 ± 6.9） mm Hg postoperatively, and recovered the preoperative level on the 3rd day after surgery. The intraocular pressure was peaked on the 1st day after surgery in study group from （ 12.9 ± 2.4） mm Hg preoperatively to （23.4 ± 8.0） mm Hg postoperatively,and recovered the preoperative level on the 3rd week after surgery. The intraocular pressure in both groups displayed an significant elevation on postoperative days, although degree of intraocular pressure elevation in study group was higher than that in control group （P 〈 0.05）. The correlation analysis showed： diabetic retinopathy, and combined with cataract extraction and lens implantation were independent risk factors of intraocular pressure surge （the intraocular pressure ≥10 mm Hg） after vitrectomy. Conclusions Phacovitrectomy and intraocular lens implantation increases the risk of transient intraocular pressure elevation in early postoperative stage than vitrectomy alone. The patients who are vulnerable to intraocular pressure fluctuations when performed a combined surgery should be paid more attention.
出处
《中国医师进修杂志》
2012年第27期4-7,共4页
Chinese Journal of Postgraduates of Medicine
作者简介
王晓鹏,Email:jhwxiaop@126.com,现在浙江省金华市中心医院眼科,321000.
