LASEK术后激素性高眼压的影响因素及临床治疗
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2015~2016年度湖北省卫生计生西医类一般项目(No.WJ2015MB218)


Influence factors and clinical treatment of high intraocular pressure after LASEK
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Research Project of Hubei Provincial Health and Family Planning Commission in 2015~2016(No. WJ2015MB218)

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    摘要:

    目的:回顾性分析LASEK术后激素性高眼压的影响因素,探讨其临床治疗方法与预后情况。

    方法:采用回顾性研究方法,选择2013-08/2016-02在我院眼科行准分子激光上皮下角膜磨镶术(laser epithelial keratomileusis,LASEK)的患者160例160眼,记录患者术后视力情况,调查高眼压发病情况与影响因素,记录高眼压的治疗方法与预后。

    结果:所有患者术中上皮瓣完整,术后存在不同程度畏光,19眼出现结膜充血、异物感明显。LASEK术后3mo的平均眼压为18.40±4.98mmHg,高于术前的16.27±2.24mmHg,两者比较差异有统计学意义(P<0.05); 术后3mo视力为1.33±0.56,明显高于术前的1.09±0.32,两者比较差异有统计学意义(P<0.05)。有9眼发生术后激素性高眼压,发病率为5.6%; 多元线性回归分析显示,切削深度(OR=3.209)、最大径线曲率(OR=3.071)、眼底C/D值(OR=9.224)为导致LASEK术后激素性高眼压的主要危险因素(P<0.05)。

    结论:LASEK术后激素性高眼压比较常见,但是对视力无明显影响,切削深度、最大径线曲率、眼底C/D值为主要的影响因素,在治疗与预防中需要谨慎使用激素类药物,定期复查和检测眼压的变化。

    Abstract:

    AIM: To analyze the influence factors of high intraocular pressure after laser epithelial keratomileusis(LASEK), and to discuss the clinical treatment and prognosis of the high intraocular pressure patients.

    METHODS: A retrospective study was used. From August 2013 to February 2016, 160 LASEK patients(160 eyes)in our hospital were selected. Visual acuity after operation was recorded. The incidence and influence factors of high intraocular pressure were investigated. The treatment method and prognosis of high intraocular pressure were recorded.

    RESULTS: In the 160 patients, all patients had complete epithelial flap and different degree of photophobia. There were 19 patients with postoperative photophobia, conjunctival hyperemia and foreign body sensation significantly. At postoperative 3mo, average intraocular pressure were 18.40±4.98mmHg, which was higher than that of preoperative, 16.27±2.24mmHg(P<0.05), and at postoperative 3mo, visual acuity was significantly higher than preoperative(P<0.05). There were 9 patients with postoperative steroid induced ocular hypertension, the incidence rate was 5.6%; Multiple linear regression analysis showed that the cutting depth(OR=3.209), maximum diameter of curvature(OR=3.071)and fundus C/D(OR=9.224)value were the main risk factors leading to postoperative steroid induced ocular hypertension(P<0.05).

    CONCLUSION: The postoperative steroid induced ocular hypertension in LASEK is common, but has no obvious effect on visual acuity. The cutting depth, maximum diameter, curvature fundus C/D value were the main influencing factors, so we should careful use the hormone drugs in treatment and prevention. Periodic review and detection for change of intraocular pressure are needed.

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雷琦峰,蔡维. LASEK术后激素性高眼压的影响因素及临床治疗.国际眼科杂志, 2017,17(2):379-381.

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  • 收稿日期:2016-10-19
  • 最后修改日期:2017-01-03
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  • 在线发布日期: 2017-01-20
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