白内障超声乳化术中高眼压的处理及原因分析

Management and cause analysis of high intraocular pressure in phacoemulsification

摘要:

目的:分析白内障超声乳化术中出现高眼压的处理方法及发病原因。方法:回顾分析白内障超声乳化手术患者408例557眼,共收集术中出现高眼压患者3例3眼。术中快速静脉滴注200g/L甘露醇250mL,其中2例2眼高血压患者分别给予降血压对症处理。观察术后第1d,1wk术眼矫正视力、眼压、角膜水肿情况。结果:囊袋阻滞综合征患者1例1眼及灌注液迷流综合征患者2例2眼用药后眼压下降,前房形成,均顺利完成超声乳化并人工晶状体植入术。3例患者术后视力均有提高；眼压均在正常范围；角膜水肿术后第1d为2级,术后1wk为0级。结论:静脉给予高渗剂是白内障超声乳化术中出现高眼压、前房形成困难的有效治疗措施。

Abstract:

AIM:To analyze the etiology and the treatment of sudden high intraocular pressure (IOP) during phacoemulsification.METHODS:Three of 408 cases (557 eyes) with cataract suffered high IOP during surgery were treated by intravenous drip of 200g/L mannitol. Two cases(2 eyes) with hypertension lowered the blood pressure. The corrected visual acuity, IOP and corneal edema of postoperative 1day, 1 week were recorded.RESULTS:The IOP of 1 case (1 eye) with capsular block syndrome and 2 cases (2 eyes) with infusion misdirection syndrome decreased after treated by medicines. All the 3 cases successfully completed the phacoemulsification surgery and intraocular lens implantation. 3 cases had better postoperative corrected visual acuity and normal IOP. The classification of corneal edema was level 2 at postoperative day 1 and level 0 at postoperative 1 week.CONCLUSION:Intravenous drip of hyperosmotic agent is an effective treatment to decrease the high IOP during surgery.