【摘要】  　　目的：了解玻璃体视网膜手术后早期眼压变化的特点和规律性。方法：玻璃体视网膜手术患者100例,其中单纯巩膜扣带术23例，单纯玻璃体切割35例，玻璃体切割+硅油填充18例和玻璃体切割+C3F8气体填充24例，采用Goldmann压平眼压计测量术前和术后7d每天眼压。观察和分析各组手术后眼压的变化，如眼压升高>25mmHg，则局部或全身应用降眼压药物治疗。结果：首次眼压升高发生于术后24h内占86.5%，术后2d占8.1%，术后3d占5.4%。单纯巩膜扣带术、单纯玻璃体切割术后24h内眼压最高，平均眼压分别为21.04±7.49mmHg和20.43±7.79mmHg，高眼压发生率分别为5/23 (21.7%)，6/35(17.1%)。硅油填充组在术后1d，气体填充组在术后2d眼压最高，平均眼压分别为25.17±8.69mmHg和29.21±10.30mmHg，两组高眼压发生率分别为10/18（55.6%），16/24（66.7%）。结论：玻璃体视网膜手术后眼压升高多发生在早期，硅油或气体填充术后高眼压发生率较高，眼压升高幅度较大。

【关键词】  玻璃体视网膜手术　眼压　C3F8;硅油

　　Regularity of variability of intraocular pressure at earlier stage after vitro-retinal surgery

    Ya-Li Liu, Yu-Zhang Hu, Xiao-Ming Chen

    West China Eye Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China

    Abstract AIM: To determine the characteristic and regularity of variability of intraocular pressure (IOP) during earlier period from the baseline after vitro-retinal surgery. METHODS: A prospective study was performed in 100 consecutive patients undergoing scleral buckling (23 cases), simple pars plana vitrectomy (35 cases), combined vitrectomy and silicone oil injection (18 cases), combined vitrectomy and C3F8 injection (24 cases). IOP was measured before surgery, and then on day 1, 2, 3, 4, 5, 6 and 7 after surgery with Goldmann applanation tonometer. If IOP>25mmHg, the anti-glaucoma medication was administrated by local or systematic therapy. RESULTS: The IOP was elevated significantly in 24 hours after surgery in 86.5% of all cases, and elevated on day 2 and 3 in 8.1% and 5.4% cases, respectively. After undergoing scleral buckling and simple pars plana vitrectomy, the highest mean postoperative IOP was 21.04±7.49mmHg and 20.43±7.79mmHg on day 1, respectively. The incidence of high IOP was 5/23 (21.7%) and 6/35 (17.1%) respectively. The highest mean postoperative IOP was 25.17±8.69mmHg at day 1 after undergoing silicone oil injection and 29.21±10.30mmHg on day 2 after C3F8 injection. The incidence of high IOP was 10/18（55.6%）and 16/24（66.7%）in the silicone oil injection group and in the C3F8 injection group, respectively. CONCLUSION: The elevated IOP occurs usually at earlier time, especially in 24 hours after vitro-retinal surgery. There were a higher incidence of high IOP and a higher IOP range after silicone oil injection and C3F8 injection. The symptom of the patients cannot be a ruler to judge IOP elevation. It is necessary to measure and control IOP early after vitro-retinal surgery.

    · KEYWORDS: vitro-retinal surgery; intraocular pressure; C3F8; silicone oil

　0 引言

    眼压升高是视网膜玻璃体手术后常见的并发症，也是成功玻璃体视网膜术后视力不同程度下降的主要原因之一。国外对视网膜玻璃体手术后眼压变化的研究较多，其中，以回顾性资料和对术后眼压升高原因的研究为主，而前瞻性资料和对眼压变化规律的研究较少。此研究旨在探讨单纯巩膜扣带术、单纯玻璃体切割、玻璃体切割+硅油填充、玻璃体切割+C3F8气体填充术后7d内的早期眼压变化规律，为临床认识和处理视网膜玻璃体手术后高眼压提供依据。

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