玻璃体视网膜手术后低眼压临床分析

摘要

目的探讨复杂性视网膜脱离经玻璃体和视网膜手术后，低眼压的发生率和危险因素。方法对142例复杂性视网膜脱离行玻璃体视网膜手术的临床资料进行回顾性分析，低眼压的诊断标准为眼压≤5 mm Hg (1 mm Hg=0.133 kPa)，并持续6个月。结果 142例中，术后1年低眼压发生率为11.3%，其中外伤性视网膜脱离和孔源性视网膜脱离术后低眼压的发生率分别为18.9%及6.7%，两组比较差异有显著性（χ2=4.89，P＜0.05）。无晶状体眼和有晶状体眼术后低眼压的发生率分别为20.9%及7.0%，两组比较差异有显著性（χ2=5.67，P<0.05）。增殖性玻璃体视网膜病变C级和D级术后低眼压的发生率分别为1.8%和15.1%，两组比较差异有显著性（χ2=3.97，P<0.05）。术前有低眼压者和无低眼压者术后低眼压的发生率分别为21.9%和6.9%，两组比较差异有显著性（χ2=5.16，P＜0.05）。结论低眼压是复杂性视网膜脱离手术后的一个并发症，眼外伤、无晶状体眼、术前低眼压及严重的增殖性玻璃体视网膜病变是发生低眼压的危险因素。%Objective　To evaluate the incidence and risk factors of hypotony in patients who have undergone vitrectomy for complex retinal detachment. Methods　The medical records of 142 patients with complex retinal detachments who underwent vitrectomy were reviewed. Hypotony was defined as a persistent intraocular pressure (IOP) of 5 mmHg or less for 6 months in the follow-up. Results　Among this 142 patients, hypotony occurred in 16 (11.3%) in 1 year postoperatively. The rate of hypotony in the patients with traumatic retinal detachment was 18.9%, and 6.7% in the patients with rhegmatogenous retinal detachment, the difference being statistically significant (χ2=4.89, P<0.05). The rate of hypotony in aphakia was 20.9%, and 7.0% for phakia, the difference being statistically significant (χ2=5.67, P<0.05). The rate of hypotony in the patients with proliferative vitreoretinopathy (PVR)-C class was l.8%, and l5.1% in the patients with PVR-D class, the difference being statistically significant (χ2=3.97, P<0.05). The rate of post-operative hypotony in the patients with preoperative hypotony was 21.9%, and. 6.9% in the patients without preoperative hypotony, the difference being statistically significant (χ2=5.16, P<0.05). Conclusions　Intraocular hypotony is a complication of vitrectomy for complex retinal detachment. The risk factors for the post-operative hypotony include trauma, aphakia, preoperative hypotony and severe PVR.