眼外伤玻璃体切除术后低眼压临床分析

目的探讨复杂性眼外伤玻璃体切除术后发生低眼压的危险因素。方法对208例（208眼）复杂性眼外伤行玻璃体切除手术的临床资料进行回顾性分析，低眼压标准为≤5mmHg持续1个月以上。结果208眼中，术后1年低眼压的发生率为19．71％。进行卡方检验表明：无晶状体眼和有晶状体眼术后低眼压的发生率分别为21．45％和17．07％，差异有统计学意义；视网膜切除和不切除术后低眼压的发生率分别为35．48％和13．00％，差异有统计学意义；玻璃体基底部切除干净与不干净术后低眼压的发生率分别为11．51％和36．25％，差异有统计学意义；术前低眼压与非低眼压术后低眼压的发生率分别为30．77％和13．08％，差异有统计学意义；术前有眼内炎与无眼内炎术后低眼压的发生率分别为33．33％与16．86％，差异有统计学意义；术前有视网膜脱离和无视网膜脱离术后低眼压的发生率分别为39．58％和13．75％，差异有统计学意义；有无睫状体破裂术后低眼压的发生率分别为35．14％和11．19％，差异有统计学意义；有无眼内异物术后低眼压的发生率分别为35．48％和41．30％，差异有统计学意义。结论术前低眼压、睫状体破裂、视网膜脱离、眼内炎、术中晶状体切除（或术前无品状体）、视网膜切除以及玻璃体基底部残留较多是复杂眼外伤玻璃体切除术后低眼压发生的危险因素。

Clinical analysis of hypotension on ocular trauma with vitrectomy

Objective To explore the incidence and dangerous factors of hypotension in complicated ocular trauma cases with vitrectomy. Methods 208 cases of complicated ocular trauma were analysised. The standard for hypotension was as follows： the mtrocular pressure was below 5 mmHg and have existed for more than one month. Results In 208 cases, the incidence of hypotension in one year after vitrectomy was 19.71%. The incidence of hypotension in cases without lens was 21.43% and cased with lens 17.07% , the two groups had significant difference （x^2 = 4. 069, P 〈 0.05 ）. The incidence of hypotension in cases with retina reseeted was 35.48% and without was 13.01% , the two groups had significant diffenrence （x^2 = 13.88, P 〈 0.05 ）. The incidence with vitreous base reserved was and resected there was significant difference in two groups （x^2 = 17.81 , P 〈0.05）. The incidence with preoperative hypotention was 30.77% and without 13.08% , the diffenrence was significant（x^2 = 9.64, P 〈 0.05 ）. The incidence with endopthalmitis was 33.33% and without 16.88% , these two groups had significant difference（x^2 = 5. 104, P 〈 0.05）. The incidences with retinal detachment was 39. 58% and without 13.75% , the two groups had significant difference （x^2 = 15.57, P 〈0.05）. The incidence with ciliary rapture was 35. 14% and without 11.91% , their difference was significant （x^2 = 17 - 26, P 〈 0.05 ） . The incidence with introcular foreign body is 35.48% and without 13.01% , their difference was significant （x^2 = 13.88, P 〈 0.05 ）. Conclusion Preoperative hypotension, ciliary rupture, retinal detachment, endopthalmitis, lensectomy, retinal resected, vitreous base reserved are all the dangerous factors for hypotension in complicated ocular trauma cases treated with vitrectomy.