硅油填充术后眼压及房角改变

目的分析硅油填充术后眼的房角改变及其与眼压升高的关系。方法对行硅油填充术后27例29只眼术后的眼压变化进行回顾性分析,硅油取出术前进行超声生物显微镜、裂隙灯显微镜及非接触眼压检查。结果29只眼中有12只眼术后出现了硅油继发性青光眼,发生率为41.4%。眼压开始升高时间从术后第2天至术后5年不等。最高眼压从29mmHg～56mmHg,平均39.5mmHg(1mmHg=0.133kPa)。超声生物显微镜和裂隙灯显微镜的检查结果显示,正常眼压组和硅油继发性青光眼组相比较,后者中前房硅油颗粒、硅油乳化、周边虹膜前粘连、无晶体眼及人工晶体眼的所占比例明显高于前者。硅油取出术后,继发性青光眼的12只眼3d内眼压全部恢复正常,1周后眼压>24mmHg的2只眼在1月后眼压>24mmHg的仅有1只眼。该眼于取硅油术后1月行睫状体光凝术,术后眼压控制。结论前房硅油颗粒、硅油乳化、周边虹膜前粘连、无晶体眼及人工晶体眼,有可能是硅油继发性青光眼的危险因素。硅油取出术是治疗硅油继发性青光眼的相对有效的方法。

Changes of Intraocular Pressure and Anterior Chamber Angle after Intravitreal Silicone Oil Injection

Objective To analyze the changes of intraocular pressure and anterior chamber angle after intravitreal silicone oil injection. Methods Retrospective analysis of intraocular pressure(IOP) was performed in 27 patients(29 eyes) after intravitreal silicone oil injection. Before the silicone oil was removed, all the eyes were examined by ultrasound biomicroscopy(UBM), slit-lamp microscope and non-contact tonometer. After the silicone oil was removed, all the eyes were examined by non-contact tonometer. Results Twelve eyes were diagnosed as silicone oil glaucoma(SOG). The incidence of SOG was 41.4%. Ocular hypertension began from the second day to 4 years after the operation during which silicone oil was injected. By ultrasound biomicroscopy and slit-lamp, It was found that there was more silicone oil in the anterior chamber, emulsified silicone oil, peripheral anterior synechia of iris, intraocular lens and aphacia in glaucoma eyes as compared with normal IOP eyes. After silicone oil removal, the IOP of most of silicone oil glaucoma eyes became normal. Conclusion Silicone oil in anterior chamber, emulsified silicone oil, peripheral anterior synechia of iris, intraocular lens and aphacia were the main causes of silicone oil glaucoma. Removing silicone oil was effective in treatment of silicone oil glaucoma.