[超声乳化术对已有功能性滤过泡的眼睛的影响]

[The effect of phacoemulsification on eyes with preexisting functional filtering blebs].

作者信息

Hong Ying, Zhang Chun, Wang Wei

机构信息

Peking University Third Hospital, Peking University Eye Center, Beijing 100083, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2009 Oct;45(10):898-902.

PMID:20137450

Abstract

OBJECTIVE

To investigate the effect of clear corneal phacoemulsification on filtering bleb morphology and filtering function in glaucoma eyes with functional filtering blebs. Analysis the risk factors of intraocular pressure (IOP) increasement after phacoemulsification.

METHOD

It was a prospective series case study. Twenty-five eyes of 20 Chinese patients who had undergone clear corneal phacoemulsification after trabeculectomy were enrolled. IOP and the numbers of antiglaucoma medicine before and 1 month, 3 months, 6 months, 12 months and 24 months after phacoemulsification were recorded. Ultrasound Biomicroscopy was conducted preoperatively, 1 month and 24 months postoperatively. Compare the IOP and the numbers of antiglaucoma medicines before and after phacoemulsification by student t test. Risk factors were evaluated for association with loss of IOP control requiring additional medications or further glaucoma surgery, using Kaplan-Meier survival analysis.

RESULTS

The IOP was (15.8 +/- 5.1) mm Hg (1 mm Hg = 0.133 kPa), (13.7 +/- 3.6) mm Hg, (13.6 +/- 3.3) mm Hg, (14.4 +/- 4.1) mm Hg, (14.2 +/- 3.6) mm Hg, (13.8 +/- 3.5) mm Hg (P = 0.007, 0.004, 0.021, 0.033, 0.004) before and at 1, 3, 6, 12, 24 months after phacoemulsification. The numbers of antiglaucoma medicine were 0.2 +/- 0.6 and 0.3 +/- 0.7 before and after phacoemulsification (P = 0.265). Log-rank analysis the risk factors include IOP higher than 15 mm Hg before phacoemusification (P = 0.042), bleb height decreased more than 10% 1 month after phacoemusification (P = 0.037) and the intrableb reflectivity increase (P = 0.001).

CONCLUSIONS

Phacoemulsification on eyes with functional filtering bleb did not affect the filtering function. Risk factors of loss of IOP control include IOP higher than 15 mm Hg before phacoemusification, bleb height decreased more than 10% and the intrableb reflectivity increase in a short term after phacoemusification.

摘要

目的

探讨透明角膜超声乳化术对功能性滤过泡的青光眼患眼滤过泡形态及滤过功能的影响。分析超声乳化术后眼压升高的危险因素。

方法

这是一项前瞻性系列病例研究。纳入20例中国患者的25只眼，这些患者在小梁切除术后接受了透明角膜超声乳化术。记录超声乳化术前、术后1个月、3个月、6个月、12个月和24个月的眼压及抗青光眼药物数量。在术前、术后1个月和24个月进行超声生物显微镜检查。采用学生t检验比较超声乳化术前、后的眼压及抗青光眼药物数量。使用Kaplan-Meier生存分析评估危险因素与眼压控制丧失（需要额外药物治疗或进一步的青光眼手术）之间的关联。

结果

超声乳化术前、术后1个月、3个月、6个月、12个月和24个月的眼压分别为（15.8±5.1）mmHg（1mmHg = 0.133kPa）、（13.7±3.6）mmHg、（13.6±3.3）mmHg、（14.4±4.1）mmHg、（14.2±3.6）mmHg、（13.8±3.5）mmHg（P = 0.007、0.004、0.021、0.033、0.004）。超声乳化术前、后的抗青光眼药物数量分别为0.2±0.6和0.3±0.7（P = 0.265）。对数秩分析显示危险因素包括超声乳化术前眼压高于15mmHg（P = 0.042）、超声乳化术后1个月滤过泡高度下降超过10%（P = 0.037）和滤过泡内反射率增加（P = 0.001）。