Wu Kevin, Lee Hyunjoo J, Desai Manishi A
Department of Ophthalmology, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA,
Clin Ophthalmol. 2018 Aug 23;12:1539-1547. doi: 10.2147/OPTH.S159592. eCollection 2018.
In this study, we aimed to identify the risk factors for early postoperative elevation of intraocular pressure (IOP) after pterygium surgery.
All patients in this retrospective cohort study were evaluated for inclusion from a single tertiary care center at Boston Medical Center. Their pre- and postoperative IOP measurements (day 1, week 1, month 1, month 3, and when clinically necessary) were compared. Patients with postoperative IOP measurement of >22 mmHg or with an increase in IOP by ≥10 mmHg compared with the preoperative measurement value were grouped as "Ocular Hypertension" group; otherwise, patients were grouped in the "No Ocular Hypertension" group. Age, sex, race, baseline IOP, cup-to-disc (C/D) ratio, history of glaucoma, and frequency of use of postoperative steroid drops in all patients were compared. Chi square test was performed to compare the categorical variables, whereas Student's -test was performed to compare continuous variables. We performed a multivariate logistic regression analysis of categorical data with a significance level of < 0.05.
In total, 240 patient charts were reviewed for inclusion in this study. Twenty-six patients required pterygium surgery on both eyes; for these patients, the eye with higher IOP was analyzed. Two patients were discontinued from this study because of elevated IOP in the contralateral, nonsurgical eye. Fortyeight out of 212 eyes (22.64%) developed postsurgical elevation of IOP within the first 3 months of operation. No significant differences were found between age, sex, baseline IOP, C/D ratio, history of glaucoma diagnoses, and frequency of use of postoperative steroid drops. However, Hispanic/Latino race ( = 0.036) and lack of application of steroid ointment ( = 0.001) were found to be the significant risk factors for the development of "Ocular Hypertension" in multivariate analysis.
Early elevation of IOP is a risk of pterygium surgery. One nonmodifiable risk factor, Hispanic/Latino race, and one modifiable risk factor, lack of application of steroid ointments, were identified as potential causes of early postoperative IOP elevation.
在本研究中，我们旨在确定翼状胬肉手术后早期眼压（IOP）升高的危险因素。
本回顾性队列研究中的所有患者均来自波士顿医疗中心的单一三级护理中心，并对其纳入情况进行评估。比较他们术前和术后的眼压测量值（第1天、第1周、第1个月、第3个月以及临床需要时）。术后眼压测量值>22 mmHg或与术前测量值相比眼压升高≥10 mmHg的患者被归为“高眼压”组；否则，患者被归为“无高眼压”组。比较所有患者的年龄、性别、种族、基线眼压、杯盘比（C/D）、青光眼病史以及术后使用类固醇滴眼液的频率。采用卡方检验比较分类变量，而采用学生t检验比较连续变量。我们对分类数据进行了多因素逻辑回归分析，显著性水平<0.05。
本研究共纳入并审查了240例患者的病历。26例患者双眼均需进行翼状胬肉手术；对于这些患者，分析眼压较高的眼睛。2例患者因对侧非手术眼眼压升高而退出本研究。212只眼中有48只（22.64%）在术后3个月内出现眼压升高。在年龄、性别、基线眼压、C/D比、青光眼诊断史以及术后使用类固醇滴眼液的频率方面未发现显著差异。然而，在多因素分析中，西班牙裔/拉丁裔种族（P = 0.036）和未使用类固醇眼膏（P = 0.001）被发现是发生“高眼压”的显著危险因素。
眼压早期升高是翼状胬肉手术的一个风险。一个不可改变的危险因素，即西班牙裔/拉丁裔种族，以及一个可改变的危险因素，即未使用类固醇眼膏，被确定为术后早期眼压升高的潜在原因。
