Reasons for early ocular hypertension after uneventful cataract surgery
Reasons for early ocular hypertension after uneventful cataract surgery
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平安白内障手术后早期高眼压的原因
DOI：
10.5301/ejo.5000441
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发表时间：
2014-09-01
影响因子：
1.7
通讯作者：
Liu, Xin
中科院分区：
文献类型：
--
作者：
Fan, Fan;Luo, Yi;Liu, Xin
目的探讨白内障超声乳化吸除联合人工透镜植入术后早期高眼压的原因及防治措施。方法回顾性分析2011年9月至2013年1月期间，在一名外科医生的实践中，药物未能控制或需要额外手术的白内障手术后早期高眼压患者。结果16个月内由同一名医生施行白内障手术的1270只眼中，12例患者12只眼（9.4‰）符合纳入标准。平均术后眼内压（IOP）峰值为41（范围32-62）mmHg。白内障手术后首次发病的中位时间为3.5天（范围1-60天）。6眼有抗青光眼手术史。Ahmed瓣植入联合丝裂霉素C（MMC）4眼。2眼行5-氟尿嘧啶针刺联合MMC翻修术。仅3眼在停用常规外用糖皮质激素后眼压下降，诊断为激素有效。摘要一位糖尿病患者的一只眼睛因血糖波动而发生人工晶状体瞳孔阻滞性闭角型青光眼。Nd：YAG激光虹膜切开术后眼压控制良好。残留皮质致高眼压2眼，行手术吸除。在监测IOP 6至24个月后，所有眼睛均在正常范围内。结论对有青光眼手术史、高度近视（尤其是年轻人）和糖尿病的患者，应特别注意白内障术后可能出现的眼压升高。
Purpose To discuss the reasons for and measurements of early ocular hypertension after uneventful phacoemulsification and intraocular lens (IOL) implantation. Methods This was a retrospective review of patients who had early ocular hypertension after cataract surgery from a single-surgeon practice that medications failed to control or required additional surgery from September 2011 to January 2013. Results Of the 1270 eyes that had cataract surgery by one surgeon in our department in 16 months, 12 (9.4‰) eyes of 12 patients met the inclusion criteria. The mean postoperative intraocular pressure (IOP) peak was 41 (range 32-62) mm Hg. The median time of initial onset after cataract surgery was 3.5 days (range 1-60 days). Six eyes had antiglaucoma surgery history. Ahmed valve implantation with mitomycin C (MMC) was applied to 4 eyes. Two eyes underwent 5-fluorouracil needling revision with MMC. The IOP dropped in 3 eyes only in the case that the conventional topical corticosteroid agent was stopped, diagnosed as steroid responders. One eye of a patient with diabetes mellitus (DM) developed pseudophakic pupillary block angle-closure glaucoma due to the plasma glucose fluctuations. The IOP was controlled after Nd:YAG laser iridotomies. Residual cortex caused ocular hypertension in 2 eyes and surgical aspirations were performed. Following monitoring of IOP for 6 to 24 months, all eyes were within the normal range. Conclusions Patients with history of glaucoma surgery; high myopia, especially in young age; and DM merit particular observation and treatment for possible IOP elevation following cataract surgery.