白内障超声乳化人工晶体植入术后早期眼压升高的原因分析

Analysis of the Causes of Early Intraocular Pressure Elevation after Phacoemulsification and Intraocular Lens Implantation

摘要: 目的：探讨白内障超声乳化人工晶体植入术后早期眼压升高的原因。方法：对我院2017年1月~2017年12月白内障超声乳化人工晶体植入手术病人397例493眼的病历资料进行回顾性分析。结果：1) 非条件Logistic回归分析结果表明：术后早期眼压升高的危险因素为粘弹剂残留、后囊膜破裂、睫状沟内植入、晶体皮质残留、前房积血、囊袋阻滞综合征、陈旧性葡萄膜炎、高度近视、糖尿病。2) 术后早期发生高眼压共29眼，均出现在术后6 h，其中粘弹剂残留13眼(44.83%)，后囊膜破裂7眼(24.14%)，睫状沟内植入5眼(17.24%)，前房积血2眼(6.89%)，皮质残留2眼(6.89%)，囊袋阻滞综合征2眼(6.89%)，葡萄膜炎1眼(3.45%)，糖尿病1眼(3.45%)，高度近视1眼(3.45%)。各个相关因素患者术后6 h眼压与术前比较，差异有统计学意义(P < 0.05)。结论：前房粘弹剂残留和后囊膜破裂是引起术后高眼压的主要原因，其次是睫状沟内植入、皮质残留、前房积血、囊袋阻滞综合征所致。术后早期眼压升高通常发生在术后6 h，要重视白内障超声乳化术后早期眼压的监测，特别是术后6 h的眼压测量。

Abstract: Objective: To investigate the causes of early intraocular pressure elevation after phacoemulsifica-tion and intraocular lens implantation. Methods: A retrospective analysis was made on the medical records of 397 cases (493 eyes) with phacoemulsification and intraocular lens implantation in our hospital from January 2017 to December 2017. Results: 1) Unconditional logistic regression analysis showed that the risk factors of early postoperative IOP elevation were viscoelastic residue, posterior capsule rupture, ciliary sulcus implantation, lens cortex residue, hyphema, capsule block syndrome, old uveitis, high myopia and diabetes mellitus. 2) Early postoperative ocular hy-pertension occurred in 29 eyes, including 13 eyes (44.83%) with viscoelastic residue, 7 eyes (24.14%) with posterior capsular rupture, 5 eyes (17.24%) with ciliary sulcus implantation, 2 eyes (6.89%) with hyphema, 2 eyes (6.89%) with cortical residue, 2 eyes (6.89%) with capsular block syndrome, 1 eye (3.45%) with uveitis, 1 eye (3.45%) with diabetes mellitus, 1 eye (3.45%) with high myopia. There was a significant difference in intraocular pressure (IOP) between 6 h and P < 0.05 after operation (6 h). Conclusion: Viscoelastic residue and posterior capsular rupture are the main causes of elevated intraocular pressure after phacoemulsification and intraocular lens implantation. Early postoperative intraocular pressure elevation usually occurs at postoperative 6 h.