復雜視網膜脱離硅油填充后的高眼壓與低眼壓

目的探討復雜性視網膜脱離平坦部玻璃體切割硅油填充后高眼壓與低眼壓的發生和危險因素.方法對62例(66眼)平坦部玻切硅油填充的復雜網脱病例進行隨訪檢查.結果隨訪至1年,高眼壓和低眼壓發生率爲31.82%和15.15%,術后第一天高眼壓與其它隨訪期比較無差异,p＞0.05.增殖性糖尿病視網膜病變和增殖性玻璃體視網膜病變及有青光眼史和糖尿病史與無上述病史的高眼壓發生率有顯著差异,分别爲p＜0.01和p＜0.05.80%術后低眼壓患者術前就存在低眼壓和無晶狀體.結論高眼壓和低眼壓是復雜網脱硅油填充術后的常見許發症,其發生率分别爲31.82%(21眼)和15.15%(10眼),前者的危險因素包括青年眼和糖尿病史及術后第一天高眼壓的發生;術前低眼壓和無晶狀體是后者的危險因素.

High or low intraocular pressure after silicone oil injection for management of complex retinal detachment

Objective To study the incidence and risk factors of persistently elevated or lowered intraocular pressure (IOP) in patients who have undergone par plana vitrectomy (PPV) with silicone oil injection for management of complex retinal detachment (RD) . Methods 62 cases (66 eyes) who had undergone PPV with silicone oil injection for the management of complex RD were followed up for 1 year. Results Elevated IOP and hypotony respectively affected 31.82% (21 eyes) and 15.15% (10 eyes) of the 66 eyes by the end of the year. There was a statistically significant difference in incidence of elevated IOP between cases with proliferative vitreoretinopathy (PVR) and those with proliferative diabetic retinopathy (PDR) (p< 0.01) .There was no difference in the incidence between the first postoperative day and other times during the follow - up ( p > 0.05) . There was difference in the incidence between the groups with or without a history of glaucoma and diabetes ( p < 0.05) Among the 10 eyes with hypotony,5 eyes (50%) had preoperative hypotony and 3 eyes (50%) had preoperative aphakia.Coclusion An elevated or lowered IOP often develops postoperativly in patients who have undergone silicone oil injection for the management of complex RD. Risk factors for postoperative high IOP include a history of glaucoma and diabetes and a high IOP on the first postoperative day. Preoperative hypotony and aphakia are risk factors for postoperative hypotony.