25G 经平坦部玻璃体切除术联合非膨胀性眼内填塞术后低眼压的发生率及危险因素。

INCIDENCE AND RISK FACTORS FOR HYPOTONY AFTER 25-GAUGE PARS PLANA VITRECTOMY WITH NONEXPANSILE ENDOTAMPONADE.

机构信息

Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; and.

Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.

出版信息

Retina. 2020 Jan;40(1):41-46. doi: 10.1097/IAE.0000000000002336.

DOI:10.1097/IAE.0000000000002336

PMID:30308563

Abstract

PURPOSE

The purpose of this study was to assess the incidence and risk factors for early postoperative hypotony after 25-gauge pars plana vitrectomy with nonexpansile endotamponade.

METHODS

A retrospective study of consecutive patients who underwent 25-G pars plana vitrectomy. Hypotony was defined as an intraocular pressure of 5 mmHg or less after surgery and ocular hypertension as an intraocular pressure greater than 21 mmHg.

RESULTS

Overall, 307 eyes of 307 patients with a mean age of 61.7 ± 14.3 of which 56.7% were males were included. Hypotony was identified in 5.2% of cases (n = 16) at Day 1 and 0.7% (n = 2) at Week 1 with no hypotony-related complications. The hypotony group had a higher number of previous vitreoretinal surgeries (1.5 ± 1.1 vs. 0.4 ± 0.7, P < 0.001) and a higher prevalence of preoperative ocular hypertension (22.2% vs. 4.8%, P = 0.02), pseudophakia (77.8% vs. 48.4%, P = 0.01), silicone oil removal (61.1% vs. 8.3%, P < 0.001), and external diathermy performed (55.6% vs. 20.1%, P = 0.001). In stepwise multivariate analysis, significant parameters were silicone oil removal (R = 16.34%, odds ratio 13.45, P < 0.001), pseudophakia (R = 5.69%, odds ratio 3.65, P = 0.03), and younger age (R = 2.68%, odds ratio 0.96, P = 0.04).

CONCLUSION

Silicone oil removal is a significant risk factor for early postoperative hypotony after 25-G pars plana vitrectomy.

摘要

目的

本研究旨在评估 25G 经平坦部玻璃体切除术后无膨胀性眼内填充物的早期术后低眼压的发生率和危险因素。

方法

对连续接受 25-G 经平坦部玻璃体切除术的患者进行回顾性研究。低眼压定义为术后眼压 5mmHg 或更低，高眼压定义为眼压大于 21mmHg。

结果

共有 307 例患者的 307 只眼纳入研究，平均年龄为 61.7±14.3 岁，其中 56.7%为男性。术后第 1 天低眼压发生率为 5.2%（n=16），第 1 周为 0.7%（n=2），无低眼压相关并发症。低眼压组既往玻璃体视网膜手术次数较多（1.5±1.1 次 vs. 0.4±0.7 次，P＜0.001），术前高眼压患病率较高（22.2% vs. 4.8%，P=0.02），白内障术后（77.8% vs. 48.4%，P=0.01），硅油取出（61.1% vs. 8.3%，P＜0.001）和行外加热（55.6% vs. 20.1%，P=0.001）的比例较高。多变量逐步分析中，显著参数为硅油取出（R=16.34%，比值比 13.45，P＜0.001）、白内障术后（R=5.69%，比值比 3.65，P=0.03）和年龄较小（R=2.68%，比值比 0.96，P=0.04）。