Wu Lihteh, Berrocal Maria H, Rodriguez Francisco J, Maia Mauricio, Morales-Canton Virgilio, Figueroa Marta, Serrano Martín, Roca José A, Arévalo J Fernando, Navarro Rodrigo, Hernández Hector, Salinas Samantha, Romero Rafael, Alpizar-Alvarez Natalia, Chico Giovanna
*Instituto de Cirugia Ocular, San José, Costa Rica; †Universidad de Puerto Rico, San Juan, Puerto Rico; ‡Fundación Oftalmológica Nacional, Universidad del Rosario, Bogotá, Colombia; §Vitreoretinal Surgery Unit, Brazilian Institute of Fighting Against Blindness, Assis/Presidente Prudente, Sao Paulo, Brazil; ¶Vitreoretinal Surgery, Universidade Federal de Sao Paulo, Sao Paulo, Brazil; **Asociación Para Evitar La Ceguera, Hospital Luis Sanchez Bulnes, Mexico, Mexico; ††Hospital Universitario Ramón y Cajal, Departamento de Retina, and VISSUM Madrid Mirasierra de Oftalmología Integral, Madrid, Spain; ‡‡Clinica Oftalmologica Centro Caracas, Caracas, Venezuela; §§Clínica Ricardo Palma, Lima, Peru; ¶¶The King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; and ***Wilmer Eye Institute, The Johns Hopkins University, Baltimore, Maryland.
Retina. 2014 Oct;34(10):1985-9. doi: 10.1097/IAE.0000000000000189.
To compare the incident rates of sustained elevation of intraocular pressure (IOP) after uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane and the unoperated fellow eye.
Retrospective multicenter study of 198 patients who underwent pars plana vitrectomy for an idiopathic epiretinal membrane that was followed for at least 12 months. The diagnosis of sustained IOP elevation was defined as an elevation of IOP ≥ 24 mmHg or an increase of ≥ 5 mmHg in the IOP from baseline on 2 separate visits that warranted the initiation of ocular hypotensive therapy. The main outcome measured was the development of sustained IOP elevation as defined above.
Patients were followed for an average of 47.3 ± 24 months (range, 12-106 months). In the vitrectomized eyes, 38 of the 198 (19.2%) patients developed elevated IOP compared with 9 of the 198 (4.5%) unoperated fellow eyes (P < 0.0001, Fisher exact test; odds ratio, 4.988). Possible risk factors include a family history of open-angle glaucoma (P = 0.0004 Fisher exact test; odds ratio, 7.206) and cataract surgery (P = 0.0270 Fisher exact test; odds ratio, 2.506).
Uncomplicated PPV seems to increase the IOP, particularly in those who are pseudophakic and have a family history of open-angle glaucoma. This increase in IOP may lead to glaucomatous damage if not managed appropriately. Patients with a previous PPV need to be followed by an ophthalmologist to monitor the IOP in the vitrectomized eye.
比较特发性视网膜前膜行单纯玻璃体切割术后眼压持续升高的发生率与未手术的对侧眼。
对198例行特发性视网膜前膜单纯玻璃体切割术且随访至少12个月的患者进行回顾性多中心研究。持续性眼压升高的诊断定义为眼压升高≥24 mmHg，或在两次独立就诊时眼压较基线升高≥5 mmHg，且需要开始降眼压治疗。主要测量指标为上述定义的持续性眼压升高的发生情况。
患者平均随访47.3±24个月（范围12 - 106个月）。在接受玻璃体切割术的眼中，198例患者中有38例（19.2%）眼压升高，而198例未手术的对侧眼中有9例（4.5%）眼压升高（P<0.0001，Fisher精确检验；比值比，4.988）。可能的危险因素包括开角型青光眼家族史（P = 0.0004，Fisher精确检验；比值比，7.206）和白内障手术（P = 0.0270，Fisher精确检验；比值比，2.506）。
单纯玻璃体切割术似乎会使眼压升高，尤其是在人工晶状体眼且有开角型青光眼家族史的患者中。如果处理不当，这种眼压升高可能导致青光眼性损害。既往行玻璃体切割术的患者需要眼科医生随访，以监测玻璃体切割术后眼的眼压。
