自体带Bruch膜视网膜色素上皮复合体移植术后早期眼压观察

Early postoperative intraocular pressure of transplantation of autologous retinal pigment epithelium-Bruch membrane complex

摘要:

目的：探讨联合自体视网膜色素上皮与Bruch膜复合体移植术后早期的眼压变化情况。

方法：选择24例25眼黄斑区域视网膜下较大面积出血的年龄相关性黄斑变性(ARMD)患者分A，B两组，A组为行常规玻璃体切割、黄斑下出血和脉络膜新生血管膜(CNV)取出术联合硅油填充术患者，B组在A组手术方式基础上联合自体视网膜色素上皮与Bruch膜复合体移植。以Goldmann眼压仪为测量工具，记录各组患者手术前1d眼压，以及术后第1wk每天上午眼压情况，对结果进行统计处理并分析其可能原因。

结果：A组患者手术眼术后第1，2d眼压及术后第1wk平均眼压、峰值眼压、高眼压发生率低于B组，其差异均具有统计学上的意义(P<0.05)，而术后第1wk内其它各天的A，B两组手术眼眼压无显著差异。

结论：对于黄斑区域视网膜下较大面积出血的ARMD，行联合自体视网膜色素上皮与Bruch膜复合体移植术较单纯行黄斑下出血和CNV取出术术后早期的眼压值及高眼压发生率略高，注意在围手术期内预防高眼压。

Abstract:

AIM: To observe the early postoperative intraocular pressure(IOP)of transplantation of autologous retinal pigment epithelium(RPE)-Bruch membrane complex after the removal of corneal neovascularization(CNV).

METHODS: A retrospective study was performed in 24 patients 25 eyes with age-related macular degeneration(ARMD)who underwent vitreoretinal surgery and related literatures were reviewed. The 24 patients 25 eyes were divided to group A(the macular subretinal hemorrhage and CNV removal surgery group, n=14)and group B(transplantation of autologous RPE-Bruch membrane complex after the removal of the CNV group, n=11). IOP was measured before surgery and then on day 1, 2, 3, 4, 5, 6 and 7 after surgery with Goldmann applanation tonometer. Two sets of IOP were counted and possible factors were analyzed for association with ocular hypertension.

RESULTS: The IOP was elevated on day 1 after surgery in 78.1% of all cases, and also elevated significantly on day 2 in 56.4% of group B, respectively. Besides, the mean postoperative IOP, the peak postoperative IOP and incidence of high IOP at week 1 was elevated significantly in group B, respectively.

CONCLUSION: Early postoperative IOP and incidence of high IOP in patients with hemorrhagic ARMD undergoing transplantation of autologous RPE-Bruch membrane complex after the removal of the CNV have significant elevation, and need for perioperative prevention of high IOP should be noted.