玻璃体切割术后高眼压的发生率和特点及相关危险因素分析

Analysis of incidence rate, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy

摘要:

目的：分析玻璃体切割术后高眼压的发生率、特点及相关的危险因素。

方法：回顾性分析在我院行PPV手术的患者146例146眼。比较患者的年龄、性别、眼别、病程和手术时间等，以了解高眼压的发生率和特点。比较患者术前原发疾病、术中处理方式、眼内填充物类型等，以分析发生高眼压的相关危险因素。

结果：患者47例术后发生高眼压，发生率为32.2%。高眼压与无高眼压患者在年龄、性别、眼别、病程和手术时间方面无统计学差别(P>0.05)。糖尿病伴单纯性玻璃体积血和伴牵拉性视网膜脱离患者高眼压发生率分别为21.1%和57.6%(P<0.05)。RD伴PVR C2级以下和C2级以上患者高眼压发生率分别为19.0%和43.8%(P<0.05)。眼外伤伴玻璃体积血和伴眼内异物患者高眼压发生率分别为25.0%和70.0%(P<0.05)。行全视网膜光凝患者高眼压发生率为50.8%，高于未行激光光凝组患者(P<0.05)。行部分视网膜光凝患者高眼压发生率为29.5%，高于未行激光光凝组患者，但二者比较并无统计学差异(P>0.05)。采用硅油、C₃F₈和单纯换气的患者术后高眼压发病率分别为59.7%，34.5%和14.5%，前两者与单纯换气比较具有统计学差异(P<0.05)。

结论：玻璃体切割术后高眼压发生率与术前原发疾病、术中处理方式和眼内填充物等因素密切相关。

Abstract:

AIM:To analyze the incidence, characteristics and related risk factors of high intraocular pressure after pars plana vitrectomy(PPV).

METHODS: Totally, 146 patients(146 eyes)undergone PPV in our hospital were selected. Age, gender, eye, course and operation time of patients were compared, in order to understand the incidence rate and characteristics of high intraocular pressure. Primary diseases, intraoperative treatment methods and intraocular tamponade type were compare, in order to analyze the related risk factors of high intraocular pressure.

RESULTS: Forty-seven patients occurred high intraocular pressure after operation, the incidence rate was 32.2%. There was no significant difference in age, gender, eye, course and operation time(P>0.05). The incidence rate in diabetic patients with simple vitreous hemorrhage and with tractional retinal detachment were 21.1% and 57.6%, respectively(P<0.05). The incidence rate in retinal detachment with PVR below grade C2 and above C2 were 19.0% and 43.8%, respectively(P<0.05). The incidence rate in ocular trauma with vitreous hemorrhage and with intraocular foreign bodies were 25.0% and 70.0%, respectively(P<0.05). The incidence rate of patients treated with panretinal photocoagulation was 50.8%, significantly higher than patients without treated with panretinal photocoagulation(P<0.05). The incidence rate of patients treated with part panretinal photocoagulation was 29.5%, higher than patients without treated with panretinal photocoagulation, but there was no statistical difference(P>0.05). The incidence rate of using silicone oil, C₃F₈ and simple ventilation were 59.7%, 34.5% and 14.5%, respectively(P<0.05).

CONCLUSION: After vitrectomy intraocular hypertension incidence and preoperative, intraoperative treatment of primary disease is closely related to factors such as the way and intraocular tamponade.