The effect of phacoemulsification on aqueous outflow facility
The effect of phacoemulsification on aqueous outflow facility
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DOI：
10.1016/s0161-6420(97)30154-7
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发表时间：
1997-08-01
期刊：
影响因子：
13.7
通讯作者：
Kopitas, E
中科院分区：
文献类型：
--
作者：
Meyer, MA;Savitt, ML;Kopitas, E
目的：虽然白内障摘出后眼内压（IOP）的控制可能至关重要，但对术后早期流出设施的变化知之甚少，我们研究了超声乳化术和结膜包膜大小对水流出设施系数(C)和IOP的影响。对74例无青光眼的白内障患者进行了研究。干预：患者随机接受单象限或双象限结膜切除术和超声乳化术。主要观察指标：术前、术后1天、1周、6周和1年由蒙面观察者评估血压计和张力图。结果：50例患者平均随访11.4个月（范围10-13个月）。术前流出流速降低的患者（以C≤0.28 μ l/min/mmHg为定义），1年后的平均流出流速从术前的0.24 +/- 0.04 μ l/min/mmHg显著改善至0.41 +/- 0.22 μ l/min/mmHg （P = 0.002, N = 19）。在所有患者中，平均术前C与末次随访之间无显著变化（0.39 +/- 0.23 vs. 0.46 +/- 0.38 μ l/min/mmHg，无显著差异[ns]， N = 50），此外，平均术前和末次IOP之间无显著变化（23.7 +/- 4.1 vs. 23.3 +/- 3.9 mmHg, ns, N = 50）。术后第1天平均IOP显著升高至27 +/- 6.2 mmHg (P = 0.001, N = 50)，术后第1天IOP升高大于8 mmHg的患者与术前相比，1年内IOP显著升高（P = 0.02, N = 12），单象限或双象限剖腹组之间(=或IOP无显著差异。结论：术前水流出系数降低的患者行超声乳化术后流出设施得到改善。超声乳化术后第1天IOP明显升高。结膜腹膜大小似乎在术后水流出设施或IOP中不起作用。
Objective: Although control of intraocular pressure (IOP) after cataract extraction may be of critical importance, little is known regarding changes in facility of outflow in the early postoperative period, The effect of phacoemulsification and conjunctival peritomy size on the coefficient of aqueous outflow facility (C) and IOP was studied,Design: Participants were assigned randomly to one of two treatment groups,Participants: Seventy-four patients with cataract and without evidence of glaucoma were studied.Intervention: Patients were randomized to receive either single- or two-quadrant conjunctival peritomy and phacoemulsification.Main Outcome Measures: Tonometry and tonography were assessed before surgery and at 1 day, 1 week, 6 weeks, and 1 year after surgery by a masked observer.Results: Fifty patients with a mean of 11.4 months' (range, 10-13 months) follow-up were analyzed. Patients with reduced preoperative facility of outflow (as defined by C less than or equal to 0.28 mu l/min/mmHg) showed a significant improvement from a mean preoperative value of 0.24 +/- 0.04 mu l/min/mmHg to 0.41 +/- 0.22 mu l/min/mmHg at 1 year (P = 0.002, N = 19). Among all patients, there was no significant change between mean preoperative C and last follow-up (0.39 +/- 0.23 vs. 0.46 +/- 0.38 mu l/min/mmHg, not significant [ns], N = 50), Furthermore, there was no significant change between mean preoperative and final IOP (23.7 +/- 4.1 vs. 23.3 +/- 3.9 mmHg, ns, N = 50). There was a significant elevation of mean IOP on postoperative day 1 to 27 +/- 6.2 mmHg (P = 0.001, N = 50), Patients with IOP elevations greater than 8 mmHg on postoperative day 1 had significantly elevated IOP at 1 year compared to preoperative values (P = 0.02, N = 12), There were no significant differences detected regarding (= or IOP between single- or two-quadrant peritomy groups.Conclusions: Outflow facility improves after phacoemulsification in patients with a reduced preoperative coefficient of aqueous outflow. Postoperative day 1 IOP is significantly elevated after phacoemulsification. Conjunctival peritomy size does not appear to play a role in aqueous outflow facility or IOP after surgery.