目的：探讨增殖性糖尿病视网膜病变玻璃体切割术后高眼压发生率及相关因素。

方法：选取2014-02/2016-02收治的110例160眼的PDR患者进行回顾性分析，统计术后不同分期PDR患者视力改善情况、高眼压发生率，分析手术引发高眼压的危险因素。

结果：Ⅳ期、Ⅴ期、Ⅵ期PDR患者术后视力改善情况比较，差异有统计学意义(P<0.01)。共发生47眼高眼压，其中术后1～2mo发生7眼、3～4mo发生12眼、5～6mo发生13眼、7～8mo发生7眼、9～10mo发生5眼、11～12mo发生3眼，总发生率29.4%。患者21眼(44.7%)经常规药物治疗后，眼压得到有效控制。6眼(12.8%)再做虹膜周边切除术重塑前后房交通后眼压恢复正常。7眼(14.9%)患者放出部分气体，眼压恢复正常； 6眼(12.8%)患者取出部分硅油眼压恢复正常。7眼(14.9%)患者行手术切除术配合局部糖皮质激素，眼压恢复正常。术前PDR分期、术前是否合并视网膜脱离、术中是否联合晶状体切除、术中是否眼内填充、术中是否行全视网膜光凝因素与术后高眼压发生有关(P<0.05)。经多因素Logistic回归分析，术前合并视网膜脱离及术中眼内填充是引起玻璃体切割术后高眼压的独立危险因素(P<0.05)。

结论：合并视网膜脱离、术中联合晶状体切除、术中眼内充填、术中行全视网膜光凝与DR玻璃体切割术后高眼压相关，其中术中联合晶状体切除、术中眼内填充与PDR分期是独立危险因素。临床应结合患者实际情况给予标准化、个性化预防措施，竭力降低术后高眼压。

METHODS: Selected in February 2014 to February 2016, 110 cases(160 eyes)of PDR patients were retrospectively analyzed; postoperative vision improvement, high intraocular pressure in patients with different stages of PDR were analyzed and related factors were detected.

RESULTS: Postoperative vision of PDR patients with stage Ⅳ, stage Ⅴ, and stage Ⅵ significantly improved(P<0.01). A total of 47 eyes had high intraocular pressure, in which there were 7 eyes during 1-2mo after operation, 12 eye during 3-4mo, 13 eyes during 5-6mo and, 7 eyes during 7-8mo, 5 eyes during 9-10mo, 3 eyes during 11-12mo, the total incidence was 29.4%. There 21 eyes(44.7%)had controlled IOP after treatment with conventional drugs; IOP of 6 eyes(12.8%)with peripheral iridectomy for recommunication between anterior and posterior chamber returned to normal; IOP of 7 eyes(14.9%)returned to normal after releasing some gas; IOP of 6 eyes(12.8%)returned to normal after taking out some silicone oil; 7 eyes(14.9%)with surgical resection and local glucocorticoid hormone. Preoperative PDR staging, whether preoperative combined with retinal detachment, whether combined with intraoperative lens removal, whether with intraoperative intraocular filling, whether pan retinal photocoagulation were factors associated with postoperative high intraocular pressure(P<0.05). After multiariable Logistic regression analysis, with retinal detachment and intraoperative intraocular filling was independent risk factors for high intraocular pressure after vitrectomy(P<0.05).

CONCLUSION: Retinal detachment, intraoperative joint lens removal, intraoperative intraocular filling, pan retinal photocoagulation is correlated with high intraocular pressure after vitrectomy. Intraoperative joint lens removal, intraoperative intraocular filling and preoperative PDR staging are independent risk factors. In clinical works, standardized and personalized treatment should be given according to the patients' situation trying to avoid the high IOP after vitrectomy.