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增殖性玻璃体视网膜病变中术后晶状体状态对眼压的影响

Influence of postoperative lens status on intraocular pressure in proliferative vitreoretinopathy.

作者信息

Tseng Joseph J, Schiff William M, Barile Gaetano R, Biscette O'Neil, Williams Steven L, Cekic Osman, Dhrami-Gavazi Elona, Chang Stanley

机构信息

Department of Ophthalmology, Columbia University College of Physicians & Surgeons, New York, New York, USA.

出版信息

Am J Ophthalmol. 2009 May;147(5):875-85, 885.e1-2. doi: 10.1016/j.ajo.2008.10.021. Epub 2009 Feb 4.

Abstract

PURPOSE

To determine the influence of lens status on postoperative intraocular pressure (IOP) in eyes undergoing vitrectomy for repair of recurrent retinal detachment (RD) resulting from proliferative vitreoretinopathy (PVR).

DESIGN

Retrospective, consecutive, nonrandomized, single-center series.

METHODS

One hundred and forty-five eyes with recurrent RD resulting from PVR were reviewed retrospectively. In all, 99 eyes underwent relaxing retinotomy at the time of surgery (68.4%). Perfluorocarbon gas (n = 60) or silicone oil (n = 85) were used as postoperative tamponades. For analysis, eyes were subdivided first based on tamponade and retinotomy status. The resultant groups then were divided further by lens status into 2 groups: aphakic eyes (aphakic group) and phakic and pseudophakic eyes (nonaphakic group).

RESULTS

Surgical reattachment was achieved in all eyes except one. Eyes receiving both silicone oil and relaxing retinotomy had the worst baseline characteristics compared with those receiving other interventions. In this subset of eyes, a significantly lower proportion of hypotony was found in those eyes that were aphakic after surgery when compared with those eyes that were nonaphakic (P = .037).

CONCLUSIONS

Surgical management of PVR often results in ultimate retinal reattachment. In eyes receiving both relaxing retinotomy and silicone oil, higher IOPs and a lower proportion of hypotony are found where a native lens or intraocular implant is absent. Removal of the lens or intraocular implant may be considered for those eyes at greatest risk of hypotony.

摘要

目的

确定晶状体状态对因增生性玻璃体视网膜病变(PVR)导致复发性视网膜脱离(RD)而接受玻璃体切除术的眼睛术后眼压(IOP)的影响。

设计

回顾性、连续、非随机、单中心系列研究。

方法

回顾性分析145例因PVR导致复发性RD的眼睛。总共有99只眼睛在手术时进行了松解性视网膜切开术(68.4%)。术后使用全氟碳气体(n = 60)或硅油(n = 85)作为填塞物。为进行分析,首先根据填塞物和视网膜切开术状态对眼睛进行细分。然后将所得组进一步按晶状体状态分为两组:无晶状体眼(无晶状体组)和有晶状体眼及人工晶状体眼(非无晶状体组)。

结果

除一只眼睛外,所有眼睛均实现了手术复位。与接受其他干预措施的眼睛相比,接受硅油和松解性视网膜切开术的眼睛基线特征最差。在这组眼睛中,术后无晶状体的眼睛与有晶状体或人工晶状体的眼睛相比,低眼压的比例明显更低(P = .037)。

结论

PVR的手术治疗通常可实现最终的视网膜复位。在接受松解性视网膜切开术和硅油治疗的眼睛中,无天然晶状体或眼内植入物的眼睛眼压较高且低眼压比例较低。对于发生低眼压风险最高的那些眼睛,可考虑摘除晶状体或眼内植入物。

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