Kohnen T, von Ehr M, Schütte E, Koch D D
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas 77030, USA.
J Cataract Refract Surg. 1996 Mar;22(2):227-37. doi: 10.1016/s0886-3350(96)80224-0.
To evaluate transient increases in intraocular pressure (IOP) after use of high-viscosity viscoelastic agents in cataract surgery.
Military Hospital, Ulm, Germany.
In a prospective, randomized study, we evaluated IOP following cataract surgery using two different viscoelastic substances (Healon, Healon GV). The viscosity of Healon GV is 10 times higher than that of Healon because of higher concentration and molecular weight. Patients having identical phacoemulsification procedures (sutureless clear corneal tunnel incision with foldable silicone lens implantation) (N = 60) and identical viscoelastic removal were assigned to groups of 15 based on viscoelastic used and removal time (20 or 40 seconds). Intraocular pressure was measured preoperatively and at 6, 24, 36, and 48 hours and 1 month postoperatively.
The highest mean IOP elevations in both viscoelastic groups were obtained at 24 hours postoperatively (2.9 mm Hg +/- 4.3 [SD] with Healon and 3.3 +/- 6.3 mm Hg with Healon GV). There were no statistically significant differences between the two viscoelastics and the two removal times during the entire follow-up period (unpaired t-test), but standard deviations were higher in the Healon GV groups at 6 and 24 hours. Two patients in the Healon groups and three in the Healon GV groups required medical treatment for IOP within the first 24 postoperative hours; however, all five patients had an IOP lower than 22 mm Hg on the second postoperative day.
Based on postoperative IOP, both viscoelastics can be equally well removed from the anterior chamber. Incidence of high IOP using high-viscosity hyaluronic acid is minimized by the described removal technique.
评估白内障手术中使用高粘度粘弹剂后眼压（IOP）的短暂升高情况。
德国乌尔姆军事医院。
在一项前瞻性随机研究中，我们使用两种不同的粘弹剂（Healon、Healon GV）评估白内障手术后的眼压。由于浓度和分子量较高，Healon GV的粘度比Healon高10倍。接受相同超声乳化手术（无缝合透明角膜隧道切口并植入可折叠硅胶晶状体）（N = 60）且粘弹剂清除方式相同的患者，根据所用粘弹剂和清除时间（20或40秒）分为每组15人的小组。术前以及术后6、24、36和48小时及1个月测量眼压。
两个粘弹剂组术后24小时的平均眼压升高幅度最高（使用Healon时为2.9 mmHg±4.3[标准差]，使用Healon GV时为3.3±6.3 mmHg）。在整个随访期间，两种粘弹剂以及两个清除时间之间无统计学显著差异（未配对t检验），但Healon GV组在6和24小时的标准差较高。Healon组有2名患者和Healon GV组有3名患者在术后头24小时内需接受眼压治疗；然而，所有5名患者术后第二天的眼压均低于22 mmHg。
基于术后眼压，两种粘弹剂从前房清除的效果同样良好。通过所述清除技术可将使用高粘度透明质酸时高眼压的发生率降至最低。
