Krupin T, Feitl M E, Bishop K I
Glaucoma Service, Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia 19104.
Ophthalmology. 1989 May;96(5):579-84. doi: 10.1016/s0161-6420(89)32846-6.
Postoperative intraocular pressure (IOP) was measured in patients with open-angle glaucoma undergoing extracapsular cataract extraction with a posterior chamber lens implant (ECCE-PC IOL). Patients considered to be under adequate medical glaucoma control had cataract surgery alone or combined with a posterior lip sclerectomy. Patients with medically uncontrolled glaucoma had cataract surgery combined with either a posterior lip sclerectomy or a trabeculectomy. Cataract surgery alone (n = 26) was associated with a significantly (P less than 0.001) increased IOP on postoperative day 1: preoperative IOP, 18.9 +/- 3.6 mmHg; postoperative IOP, 34.2 +/- 12 mmHg. An IOP rise of 10 mmHg or more occurred in 69% of the eyes, whereas 77% of the eyes had an absolute IOP over 25 mmHg. Eyes undergoing combined surgery (n = 42) had a preoperative IOP of 21.3 +/- 4.8 mmHg. On postoperative day 1, the mean IOP was 14.9 +/- 12.0 mmHg. An IOP rise of 10 mmHg or more was observed in 14%, and an IOP over 25 mmHg in 21% of combined surgery eyes. Cataract surgery in eyes with open-angle glaucoma requires careful monitoring and therapy for early postoperative increases in IOP. Combined surgery reduces the frequency and magnitude of, but does not eliminate, this complication.
对接受白内障囊外摘除联合后房型人工晶状体植入术（ECCE-PC IOL）的开角型青光眼患者进行术后眼压（IOP）测量。被认为青光眼得到充分药物控制的患者仅接受白内障手术或联合后唇巩膜切除术。药物治疗无法控制青光眼的患者接受白内障手术并联合后唇巩膜切除术或小梁切除术。仅行白内障手术（n = 26）的患者术后第1天眼压显著升高（P < 0.001）：术前眼压为18.9 +/- 3.6 mmHg；术后眼压为34.2 +/- 12 mmHg。69%的患眼眼压升高10 mmHg或更多，而77%的患眼绝对眼压超过25 mmHg。接受联合手术（n = 42）的患眼术前眼压为21.3 +/- 4.8 mmHg。术后第1天，平均眼压为14.9 +/- 12.0 mmHg。联合手术的患眼中，14%观察到眼压升高10 mmHg或更多，21%的患眼眼压超过25 mmHg。开角型青光眼患者的白内障手术需要密切监测并治疗术后早期眼压升高。联合手术可降低这种并发症的发生率和严重程度，但并不能消除该并发症。
