Fang Yuan, Long Qingqing, Wang Xiaoqian, Jiang Rui, Sun Xinghuai
Department of Ophthalmology and Visual Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai.
Department of Ophthalmology, Jiangyin Bright Eye Hospital, Jiangyin, Jiangsu.
Clin Ophthalmol. 2017 Nov 22;11:2091-2097. doi: 10.2147/OPTH.S144985. eCollection 2017.
The aim of this study was to investigate the incidence, risk factors, and treatment of elevated intraocular pressure (IOP) 1 year after vitrectomy in eyes without a history of glaucoma or ocular hypertension.
This retrospective study comprised 256 eyes from 256 consecutive patients without a history of glaucoma or ocular hypertension who underwent vitrectomy and were followed up for 1 year. The incidence of elevated IOP at 1 year after vitrectomy was calculated. We compared the characteristics of patients with or without elevated IOP to identify possible risk factors for elevated IOP. The treatments used to control IOP were recorded and analyzed.
A total of 50 patients (19.5%) had elevated IOP after vitrectomy at the 1-year follow-up. Tamponade was a significant risk factor for elevated IOP (<0.05). The cumulative rates of elevated IOP in eyes with air, balanced salt solution, sulfur hexafluoride, perfluoropropane (C3F8), and silicone oil as the tamponade were 0, 10.8%, 5.9%, 19.8%, and 28.4%, respectively (<0.05). About 68% of cases of elevated IOP occurred within 1 month after vitrectomy. At 1 year after vitrectomy, 29 patients (58.0%) had stopped their IOP-lowering drugs and 21 (42.0%) patients were continuing these drugs. About 65% of ocular hypertension patients who received silicone oil tamponade had not stopped IOP-lowering drugs; this rate was significantly greater than that of ocular hypertension patients who received C3F8 tamponade (18.2%, <0.05).
Elevated IOP is a common complication after vitrectomy. Silicone oil tamponade was associated with greater risk of elevated IOP and had long-term effects on IOP. Drugs and surgery were used to control IOP, and some patients required long-term IOP-lowering therapy.
本研究旨在调查无青光眼或高眼压病史的眼在玻璃体切除术后1年眼压升高的发生率、危险因素及治疗情况。
本回顾性研究纳入了256例连续的无青光眼或高眼压病史且接受了玻璃体切除术并随访1年的患者的256只眼。计算玻璃体切除术后1年眼压升高的发生率。我们比较了眼压升高和未升高患者的特征,以确定眼压升高的可能危险因素。记录并分析用于控制眼压的治疗方法。
在1年随访时,共有50例患者(19.5%)在玻璃体切除术后眼压升高。眼内填充是眼压升高的一个显著危险因素(<0.05)。以空气、平衡盐溶液、六氟化硫、全氟丙烷(C3F8)和硅油作为眼内填充时,眼压升高的累积发生率分别为0、10.8%、5.9%、19.8%和28.4%(<0.05)。约68%的眼压升高病例发生在玻璃体切除术后1个月内。玻璃体切除术后1年,29例患者(58.0%)停用了降眼压药物,21例患者(42.0%)仍在继续使用这些药物。接受硅油填充的高眼压患者中约65%未停用降眼压药物;这一比例显著高于接受C3F8填充的高眼压患者(18.2%,<0.05)。
眼压升高是玻璃体切除术后常见的并发症。硅油填充与眼压升高的风险增加相关,且对眼压有长期影响。使用药物和手术来控制眼压,一些患者需要长期的降眼压治疗。