单纯玻璃体切除术后高眼压的临床观察

目的　探讨单纯玻璃体切除术后眼压的变化规律及可能与术后高眼压发生相关的因素。设计　前瞻性、非对照干预研究。研究对象　2 8例(31只眼)行单纯玻璃体切除手术的患者。方法　观察由同一术者经睫状体平坦部行单纯玻璃体切除手术患者,记录病史、检查、手术情况,Goldmann眼压计测量术前,术后2、6、2 4小时,第2、3天,第1、2周,第1、2、3个月的眼压。主要指标　眼压。结果　术后2、6、2 4小时的眼压分别为(2 1 0 8±7 78)mmHg、(2 2 97±7 96 )mmHg、(2 0 5 0±6 19)mmHg ,分别比术前眼压高4 2 5mmHg、6 13mmHg、3 6 6mmHg(P =0 0 0 2 ,P =0 0 0 0 ,P =0 0 0 5 )。术后第2、3天、第1、2周、第1、2、3个月的眼压同术前眼压相比,差异无显著性意义。31只眼中,术后2小时内出现眼压高峰者14只眼(45 2 % ) ,6小时内者2 5只眼(80 7% )。在此期间内,有8只眼(2 5 8% )眼压≥35mmHg。术后1周时,73 7%的高眼压恢复正常。未发现高眼压与术前眼压、糖尿病、术中眼内光凝量之间的相关关系。结论　单纯玻璃体切除术后眼压高峰发生在手术后2～6小时,当术眼眼压高于35mmHg时需要及时处理;术后高眼压的持续时间短,多数患者在术后1周眼压可恢复正常。

Clinical observation of hypertony after simple pars plana vitrectomies

Objective To investigate the regulations of changes in ocular tension and the possible factors of postoperative ocular hypertension after simple pars plana vitrectomy (PPV).Design Prospective,noncomparative,interventional case series.Participants 28 patients (31 eyes) who had been operated with simple PPV.Methods The study was performed in patients who had been operated with simple PPV by one ophthalmologist.Medical histories and examination were done by the same ophthalmologist.Intraocular pressures (IOP) were measured with Goldmann tonometer at 2,6,24 hours,and 2,3days before surgery,and 1,2 weeks,1,2,3 months postoperatively.Main Outcome Measures Intraocular pressure.Results The postoperative IOP at 2,6 hours and 1 day were higher than the preoperative IOP.The apex of IOP occurred at 2 hours postoperatively in 14 eyes(45.2%) and occurred at 6 hours postoperatively in 25 eyes (80.7%).The ocular hypertension last one week.There are no significant correlation between preoperative hypertony and IOP,diabetes mellitus and laser endophotocoagulation.Conclusions The apex of IOP occurs in 6 hours after surgery,and it needs to be treated early.Most of the hypertony will return to normal at one week postoperatively.