[1]李杰,刘三梅,李芳,等.微创玻璃体切割术联合与不联合白内障手术对术后早期眼压波动的影响[J].眼科新进展,2018,38(8):732-735.[doi:10.13389/j.cnki.rao.2018.0172]
　LI Jie,LIU San-Mei,LI Fang,et al.Influence of early postoperative IOP after combined microincision vitrectomy and cataract surgery[J].Recent Advances in Ophthalmology,2018,38(8):732-735.[doi:10.13389/j.cnki.rao.2018.0172]
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微创玻璃体切割术联合与不联合白内障手术对术后早期眼压波动的影响/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年8期
页码:
732-735
栏目:
应用研究
出版日期:
2018-08-05

文章信息/Info

Title:
Influence of early postoperative IOP after combined microincision vitrectomy and cataract surgery
作者:
李杰; 刘三梅; 李芳; 董文韬; 钟捷
610072　四川省成都市，四川医学科学院、四川省人民医院、电子科技大学医学院
Author(s):
LI Jie; LIU San-Mei; LI Fang; DONG Wen-Tao; ZHONG Jie
Department of Ophthalmology，Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital；School of Medicine，University of Electronic Science and Technology of China，Chengdu 610072，Sichuan Province，China
关键词:
微创玻璃体切割术; 白内障手术; 高眼压; 低眼压; 眼压波动
Keywords:
microincision vitrectomy surgery; cataract surgery; ocular hypertension; ocular hypotony; fluctuation of intraocular pressure
分类号:
R779.62
DOI:
10.13389/j.cnki.rao.2018.0172
文献标志码:
A
摘要:
目的　探讨微创玻璃体切割术联合与不联合白内障手术对术后早期眼压波动的影响。方法　回顾性分析2016 年4 月至2017 年10 月在我院开展的微创玻璃体切割术（25G或27G）联合白内障手术的患者47例（47眼）（联合手术组）和同期行单纯玻璃体切割术的患者170例（170眼）（单纯玻切术组）的临床资料，术后随访1~3个月，记录视力及眼压情况，尤其记录术后1 d、2 d、3 d及7 d患者的眼压。结果　术后1周内，单纯玻切术组眼压波动为（6.1±7.6）mmHg（1 kPa=7.5 mmHg），高于联合手术组的眼压波动（3.3±5.0）mmHg，差异具有统计学意义（t=2.404，P=0.017）。单纯玻切术组高眼压、低眼压发生率分别为12.9%及19.4%，联合手术组分别为8.5%、8.5%，差异均无统计学意义（χ2=0.685，P=0.408；χ2=3.094，P=0.079）。而单纯玻切术组大幅眼压波动发生率为24.1%（41眼），联合手术组为8.5%（4眼），两组相比差异具有统计学意义（χ2=5.456，P=0.019）。结论　与单纯玻璃体切割术相比，玻璃体切割术联合白内障手术术后早期高眼压、低眼压发生率无显著差异。但联合手术术后早期眼压大幅波动的发生率比单纯玻璃体切割术低，维持术后眼压稳定可能是联合手术的优点之一。
Abstract:
Objective　To compare the early fluctuation of postoperative intraocular pressure (IOP) between microincision vitrectomy surgeries (MIVS) combined with and without phacoemulsification plus intraocular lens implantation in patients with vitreoretinal diseases.Methods　This study retrospectively reviewed patients who underwent primary 25-gauge or 27-gauge MIVS between April，2016 and Oct，2017.Forty-seven eyes that underwent combined vitrectomy and cataract surgery (combined group) were compared with that of 170 eyes that underwent vitrectomy only (vitrectomy group)，and totally 217 eyes were included.The main measurements were short-term best corrected visual acuity and IOP on day 1，2，3，and 7.Results　In the first postoperative week，the mean fluctuation of IOP in vitrectomy group was (6.1 ± 7.6)mmHg (1 kPa=7.5 mmHg)，which was significantly higher than that of the combined group ［(3.3 ± 5.0)mmHg，t=2.404，P=0.017］.The incidence of IOP elevation and hypotony in vitrectomy group were 12.9% and 19.4%，respectively，which were comparable to that of the combined group (both of them were 8.9%)，and there was no significant difference (χ2=0.685，P=0.408；χ2=3.094，P=0.079，respectively).However，the incidence of high IOP fluctuation in vitrectomy group was 24.1%(41 eyes)，which was significant higher than that of combined group (8.5%，4 eyes) (χ2=5.456，P=0.019).Conclusion　Compared to vitrectomy alone，there were no significant difference in the incidence of early postoperative ocular hypertension and hypotony in combined vitrectomy and cataract surgery.The maintenance of a stable IOP with a low incidence of high IOP fluctuation may be an additional advantage of combine vitrectomy and cataract surgery.

参考文献/References:

［1］　FUJII G Y，DE JUAN E，HUMAYUN M S，PIERAMICI D J，CHANG T S，AWH C，et al.A new 25-gauge instrument system for transconjunctival sutureless vitrectomy surgery［J］.Ophthalmology，2002，109（10）：1807-1812.
［2］　ECKARDT C.Transconjunctival sutureless 23-gauge vitrectomy［J］.Retina，2005，25（2）：208-211.
［3］　OSHIMA Y，WAKABAYASHI T，SATO T，OHJI M，TANO Y.A 27-gauge instrument system for transconjunctival sutureless microincision vitrectomy surgery［J］.Ophthalmology，2010，117（1）：93-102.
［4］　LIU S M，ZHONG J，FAN Y C.A comparative analysis of 23-gauge versus 20-gauge vitrectomy for the treatment of retinal detachment［J］.Pract J Clin Med，2013，10（2）：113-115.
刘三梅，钟捷，樊映川.20-G与23-G玻璃体切割术治疗视网膜脱离的对比分析［J］.实用医院临床杂志，2013，10（2）：113-115.
［5］　LI J，LIU S M，LI F，ZHONG J.Progress and application of 27-gauge microincision vitrectomy［J］.Int Eye Sci，2016，16（8）：1483-1486.
李杰，刘三梅，李芳，钟捷.27G微创玻璃体切除手术的发展及应用［J］.国际眼科杂志，2016，16（8）：1483-1486.
［6］　ZHANG Z D，SONG Y P，WANG Y Q，TANG H F，LI X H.The application of 25G micro-invasion vitrectomy in posterior segment［J］.Chin J Pract Ophthalmol，2013，31（3）：321-323.
张招德，宋晏平，王雨晴，唐涵锋，李向华.25G微创眼后段玻璃体切割术的临床应用 ［J］.中国实用眼科杂志，2013，31（3）：321-323.
［7］　RIZZO S，GENOVESI-EBERT F，MURRI S，BELTING C，VENTO A，CRESTI F，et al.25-gauge，sutureless vitrectomy and standard 20-gauge pars plana vitrectomy in idiopathic epiretinal membrane surgery：a comparative pilot study［J］.Graefes Arch Clin Exp Ophthalmol，2006，244（4）：472-479.
［8］　ANDERSON N G，FINEMAN M S，BROWN G C.Incidence of intraocular pressure spike and other adverse events after vitreoretinal surgery［J］.Ophthalmology，2006，113（1）：42-47.
［9］　YANG H K，WOO S J，PARK K H，PARK K H.Intraocular pressure changes after vitrectomy with and without combined phacoemulsification and intraocular lens implantation［J］.Korean J Ophthalmol，2010，24（6）：341-346.
［10］　LEE J Y，JEONG H S，LEE D Y，SOHN H J，NAM D H.Early postoperative intraocular pressure stability after combined 23-gauge sutureless vitrectomy and cataract surgery in patients with proliferative diabetic retinopathy［J］.Retina，2012，32（9）：1767-1774.
［11］　BAMONTE G，MURA M，STEVIE-TAN H.Hypotony after 25-gauge vitrectomy［J］.Am J Ophthalmol，2011，151（1）：156-160.
［12］　RIZZO S，POLIZZI S，BARCA F，CAPOROSSI T，VIRGILI G.Comparative study of 27-gauge versus 25-gauge vitrectomy for the treatment of primary rhegmatogenous retinal detachment［J］.J Ophthalmol，2017，2017：6384985.
［13］　KUNIKATA H，NISHIDA K.Visual outcome and complications of 25-gauge vitrectomy for rhegmatogenous retinal detachment；84 consecutive cases［J］.Eye，2010，24（6）：1071-1077.
［14］　KHAN M A，SHAHLAEE A，TOUSSAINT B，HSU J，SIVALINGAM A，DUGEL P U，et al.Outcomes of 27 gauge microincision vitrectomy surgery for posterior segment disease［J］.Am J Ophthalmol，2016，161(1)：36-43.
［15］　ZHANG Q，JIANG C G，GUO L Y.Effective of intraocular pressure fluctuation on retinal microcirculation in glaucomatous patients［J］.J Kunming Med Univ，2008，29（2）：74-76.
张青，江春光，郭立云.眼压波动对青光眼视网膜微循环的影响［J］.昆明医学院学报，2008，29（2）：74-76.
［16］　BENGTSSON B，LESKE M C，HYMAN L，HEIJL A.Fluctuation of intraocular pressure and glaucoma progression in the early manifest glaucoma trial［J］.Ophthalmology，2007，114（2）：205-209.
［17］　WU S Y，LV F，ZHOU R W，YAO P X，JIANG J W，WANG Z L，et al.Curative effects of micro-invasive combined surgery for vitreoretinopathy with cataract［J］.Rec Adv Ophthalmol，2016，36（3）：275-277.
吴松一，吕帆，周瑞武，姚鹏翔，蒋建伟，王振亮，等.微创联合手术治疗玻璃体视网膜病变合并白内障的疗效分析［J］.眼科新进展，2016，36（3）：275-277.
［18］　SISK R A，MURRAY T G.Combined phacoemulsification and sutureless 23-gauge pars plana vitrectomy for complex vitreoretinal diseases［J］.Br J Ophthalmol，2010，94（8）：1028-1032.
［19］　SHARMA Y R，PRUTHI A，AZAD R V，KUMAR A，MANNAN R.Impact of early rise of intraocular pressure on visual outcome following diabetic vitrectomy［J］.Indian J Ophthalmol，2011，59（1）：37-40.
［20］　PARK S P，AHN J K，LEE G H.Morphologic changes in the anterior segment after phacovitrectomy for proliferative diabetic retinopathy［J］.J Cataract Refract Surg，2009，35（5）：868-873.
［21］　BIRINCI H.Surgical results of triamcinolone assisted pars plana vitrectomy combined with phacoemulsification in diabetic patients［J］.Open Ophthalmol J，2008，2：5-8.
［22］　COMSTOCK T L，PATERNO M R，SINGH A，ERB T，DAVIS E.Safety and efficacy of loteprednol etabonate ophthalmic ointment 0.5%for the treatment of inflammation and pain following cataract surgery［J］.Clin Ophthalmol，2011，5(2)：177-186.
［23］　STEWART W C，CHORAK R P，HUNT H H，SETHURAMAN G.Factors associated with visual loss in patients with advanced glaucomatous changes in the optic nerve head［J］.Am J Ophthalmol，1993，116（2）：176-181.
［24］　DUAN X C，LI N.To control intraocular pressure fluctuations and its peak are equally important［J］.Ophthalmol CHN，2011，20（1）：9-12.
段宣初，李宁.控制眼压波动与眼压峰值同等重要［J］.眼科，2011，20（1）：9-12.

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备注/Memo

备注/Memo:
国家自然科学基金青年项目（编号：81700841）
更新日期/Last Update: 2018-08-09