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透明角膜微小切口与小切口白内障手术后眼压的即刻变化

Immediate changes in intraocular pressure after clear corneal micro-incision versus small-incision cataract surgery.

作者信息

Hayashi Ken, Yoshida Motoaki, Yoshimura Koichi

机构信息

Hayashi Eye Hospital, 4-23-35 Hakataekimae, Hakata-Ku, Fukuoka, 812-0011, Japan,

出版信息

Jpn J Ophthalmol. 2014 Sep;58(5):402-8. doi: 10.1007/s10384-014-0331-7. Epub 2014 Jun 28.

Abstract

PURPOSE

We sought to examine changes in intraocular pressure (IOP) in the immediate period after clear corneal micro-incision cataract surgery (MICS) and after small-incision cataract surgery (SICS).

METHODS

Sixty-eight eyes of 34 patients scheduled for coaxial phacoemulsification were randomized into one of two groups: (a) eyes that were to undergo a 2.0-mm MICS, and (b) a 2.65-mm SICS. At the conclusion of surgery, the IOP was adjusted to the range between 15-40 mmHg with stromal hydration. The IOP was measured using a rebound tonometer preoperatively, at the conclusion of surgery, and at 3, 6, 9, 12, and 15 min postoperatively. The Seidel test and anterior segment-optical coherence tomography were performed at 20 min postoperatively.

RESULTS

Mean IOP at the conclusion of surgery was 27.7 ± 4.7 mmHg in the MICS group and 29.7 ± 5.1 mmHg in the SICS group (p = 0.1239). In both groups, mean IOP decreased to the preoperative level within 9 min postoperatively and did not change significantly for up to 15 min. Mean IOP was similar between the MICS and SICS groups throughout the observation period (p ≥ 0.1239). Hypotony (≤10 mmHg), positive Seidel test, and loss of wound coaptation were not detected in all eyes.

CONCLUSIONS

After adjusting the IOP to a relatively high level at the conclusion of surgery, the IOP decreased within 9 min and was stable within 15 min without hypotony. The IOP was comparable between eyes after MICS and SICS, and both incisions virtually closed within 20 min postoperatively.

摘要

目的

我们试图研究透明角膜微小切口白内障手术(MICS)和小切口白内障手术(SICS)后即刻眼压(IOP)的变化。

方法

将34例计划行同轴超声乳化术的患者的68只眼随机分为两组:(a)接受2.0毫米MICS的眼,和(b)2.65毫米SICS的眼。手术结束时,通过基质水合作用将眼压调整到15 - 40 mmHg之间。术前、手术结束时以及术后3、6、9、12和15分钟使用回弹眼压计测量眼压。术后20分钟进行Seidel试验和眼前节光学相干断层扫描。

结果

MICS组手术结束时平均眼压为27.7 ± 4.7 mmHg,SICS组为29.7 ± 5.1 mmHg(p = 0.1239)。两组患者术后9分钟内平均眼压均降至术前水平,且在15分钟内无明显变化。在整个观察期内,MICS组和SICS组的平均眼压相似(p≥0.1239)。所有眼中均未检测到低眼压(≤10 mmHg)、Seidel试验阳性和伤口贴合不良。

结论

手术结束时将眼压调整到相对较高水平后,眼压在9分钟内下降,并在15分钟内保持稳定,无低眼压。MICS和SICS术后眼压相当,且两个切口在术后20分钟内几乎均已闭合。

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