摘要
目的探讨不同疾病下玻璃切除术后早期高眼压发生率和相关的危险因素。方法回顾性分析2015年1月至2017年3月于我院眼科中心行玻璃体切除术(PPV)患者310例(323只眼)。比较患者性别、术前原发病、术中操作、眼内填充物和是否伴有高度近视,以了解高眼压的发生率,分析PPV术后发生高眼压的危险因素。结果有43只眼出现高眼压,发生率为13. 3%。视网膜脱离、IV期及以上糖尿病性视网膜病(DR)、单纯玻璃体积血、黄斑裂孔患者术后高眼压发生率分别为24. 3%、15. 1%、6. 9%和1. 8%,差异具有统计学意义(P <0. 001)。行光凝和未行光凝患者高眼压发生率分别为17. 5%和5. 9%,差异具有统计学意义(P <0. 01),行冷凝和未行冷凝患者高眼压发生率分别为27. 6%和7. 1%,差异具有统计学意义(P <0. 0001)。术中行硅油填充、气体填充和未行眼内填充患者高眼压发生率分别为19. 4%、15. 8%和0. 9%,差异具有统计学意义(P <0. 0001)。伴有高度近视的患者PPV术后早期高眼压的发生率明显高于不伴有高度近视的患者,差异具有统计学意义(P <0. 001),并且高眼压的发生和高度近视具有明显的相关性(r=0. 214,P <0. 01)。Logistic回归分析提示光凝、冷凝、硅油填充和气体填充是PPV术后高眼压的独立危险因素。结论 PPV术后早期高眼压的发生和原发病、术中操作和眼内填充物有着密切关系。高度近视与术后高眼压的发生明显相关。光凝、冷凝和眼内填充是PPV术后发生高眼压的独立危险因素。对PPV术后患者应严密监测眼压变化,尤其是视网膜脱离和IV期及以上DR患者。
Objective To investigate the incidence and risk factors of high intraocular pressure(IOP)at early stage after pars plana vitrectomy(PPV)in different diseases.Methods We retrospectively analyzed 323 eyes of 310 patients who underwent PPV in our hospital from January 2015 to March 2017.Gender,preoperative primary disease,intraoperative procedures,intraocular tamponade and the presence of accompanying high myopia were assessed to analyze the incidence and risk factors of high IOP at early stage after PPV.Results 43 eyes demonstrated high IOP after the surgery with an incidence of 13.3%.The incidence of high IOP for patients with retinal detachment,stage IV and above diabetic retinopathy,simple vitreous hemorrhage and macular hole was 24.3%,15.1%,6.9% and 1.8%,respectively(P<0.001).The incidence of high IOP was 17.5% in the photocoagulation group and 5.9% in the non-photocoagulation group,with a statistically significant difference(P<0.01).The incidence of high IOP in the retinal?cryotherapy group was significantly higher than in the non-retinal cryotherapy group(27.6% vs.7.1%,P<0.0001).The incidence of high IOP in patients with silicone oil tamponade,air tamponade and without any tamponade was 19.4%,15.8% and 0.9%,respectively,and the difference was significant(P<0.0001).The incidence of high IOP in patients with high myopia was significantly higher than those without high myopia(P<0.001),and there was a significant association between incident high IOP and high myopia(r=0.214,P<0.01).Logistic regression analysis showed that photocoagulation,retinal cryotherapy,silicone oil tamponade and air tamponade were independent risk factors for high IOP after PPV.Conclusions The occurrence of high IOP early after PPV is closely related to the primary disease,intraoperative procedures and intraocular tamponades.High myopia is associated with postoperative IOP elevation.Photocoagulation,retinal cryotherapy and intraocular tamponade are independent risk factors for high IOP after PPV.The changes of IOP after PPV should be closel
作者
杨家翼
贺涛
邢怡桥
Yang Jiayi;He Tao;Xing Yiqiao(Eye Center,Renmin Hospital of Wuhan University,Wuhan,Hubei Province 430060,China)
出处
《临床眼科杂志》
2019年第2期129-133,共5页
Journal of Clinical Ophthalmology
关键词
玻璃体切除术
高眼压
危险因素
Pars plana vitrectomy
High intraocular pressure
Risk factors
