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硅油填充眼经经结膜无缝线玻璃体切除术后继发眼高压的危险因素:前瞻性队列研究。

Risk factors for secondary ocular hypertension in silicone oil-filled eyes following transconjunctival sutureless vitrectomy - A prospective cohort study.

机构信息

Department of Ophthalmology, Amrita Vishwa Vidyapeetham, Amrita School of Medicine, Kochi, Kerala, India.

出版信息

Indian J Ophthalmol. 2023 Feb;71(2):595-600. doi: 10.4103/ijo.IJO_1777_22.

Abstract

PURPOSE

Our aim was to determine the various risk factors for secondary ocular hypertension (OHT) following pars plana vitrectomy (PPV) with silicone oil (SO) injection.

METHODS

A prospective cohort study was performed on 46 eyes of 42 patients who underwent PPV with SO injection under a single surgeon between January 2020 and July 2021. Complete ophthalmological examination including gonioscopy and Goldmann applanation tonometry was performed preoperatively and on three postoperative visits, that is, day 7, day 30, and day 90. Axial length and lens thickness were measured at baseline using immersion A-scan. Anterior segment optical coherence tomography (OCT) was used for measuring anterior chamber depth (ACD) at baseline and at 3 months.

RESULTS

There was a statistically significant increase in intraocular pressure (IOP) (>21 mmHg) on day 7 (4.70 ± 7.754 mmHg), day 30 (5.24 ± 7.481 mmHg), and day 90 (2.39 ± 5.659 mmHg) (P<0.01 for all). Age <50 years, rhegmatogenous retinal detachment (RRD), and pseudophakia had a strong association with short-term OHT on day 7. Preexisting glaucoma was the only independent risk factor for long-term OHT (day 90). Higher baseline IOP and SO emulsification also contributed to long-term OHT.

CONCLUSION

There was a statistically significant elevation in IOP at all postoperative visits. Short-term OHT was associated with younger age (<50 years), RRD, and pseudophakia. Patients with emulsified SO in the anterior chamber, higher baseline IOP, and preexisting glaucoma were at higher risk for long-term OHT.

摘要

目的

本研究旨在确定行巩膜外冷凝和玻璃体切割术联合硅油(SO)眼内填充术后发生继发性高眼压(OHT)的各种危险因素。

方法

前瞻性队列研究纳入了 2020 年 1 月至 2021 年 7 月期间由同一位外科医生行巩膜外冷凝和玻璃体切割术联合 SO 眼内填充术的 42 例患者的 46 只眼。所有患者术前和术后 3 次随访(第 7、30 和 90 天)均行全面眼科检查,包括房角镜和压平眼压计测量。基线时使用接触式 A 型超声测量眼轴长度和晶状体厚度。采用眼前节光学相干断层扫描(OCT)测量基线和 3 个月时的前房深度(ACD)。

结果

第 7、30 和 90 天的眼压(IOP)(>21mmHg)分别显著升高(4.70±7.754mmHg、5.24±7.481mmHg 和 2.39±5.659mmHg,均 P<0.01)。年龄<50 岁、孔源性视网膜脱离(RRD)和白内障术后是第 7 天发生短期 OHT 的强烈危险因素。术前青光眼是长期 OHT(第 90 天)的唯一独立危险因素。较高的基线 IOP 和 SO 乳化也与长期 OHT 有关。

结论

所有术后随访时 IOP 均显著升高。短期 OHT 与年龄较小(<50 岁)、RRD 和白内障术后有关。前房存在乳化 SO、基线 IOP 较高和术前青光眼的患者发生长期 OHT 的风险较高。

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