有晶体眼人工晶体植入术后高眼压临床分析.docVIP

有晶体眼人工晶体植入术后高眼压临床分析 　　[摘要] 目的 总结有晶体眼后房型人工晶体又称植入型接触镜（ICL）植入术后高眼压的发生原因，探讨其防治方法。 方法 收集2011年1月～2014年5月在西安市第四医院住院的高度近视患者54例（108眼），均行有晶体眼人工晶体植入术。术后随访3个月，随访项目包括裸眼视力、最佳矫正视力、眼压、裂隙灯检查、眼底检查、人工晶体的拱高。 结果 术后1 d至术后3个月所有患者裸眼视力均达到或超过术前最佳矫正视力。有13眼术后第1天发生高眼压，眼压25～38.8 mmHg，给予局部、全身降眼压药物或前房穿刺放房水等治疗后，10眼在术后第3天眼压恢复正常水平，2眼在术后第7天停用糖皮质激素滴眼液后眼压逐渐下降。其中有1例患者双眼术后药物治疗1个月，眼压仍控制不良，行人工晶体更换手术。术后3个月随访结束时，所有患者眼压均正常。术后1个月超声生物显微镜测量人工晶体拱高0.5～1.04 mm，人工晶体均未与自身晶状体接触，术后3个月随访自身晶状体无混浊表现。 结论 有晶体眼人工晶体植入术后高眼压有多种原因，根据病因给予相应的治疗，患者眼压均可恢复正常。 　　[关键词] 有晶体眼人工晶体植入；高度近视；高眼压 　　[中图分类号] R776 [文献标识码] A [文章编号] 1673-7210（2015）09（c）-0116-04 　　[Abstract] Objective To summarize the reasons of high intraocular pressure （IOP） after implantable collamer lens implantation， discuss the treatment and prevention method. Methods 108 eyes of 54 patients with high myopia in the Fourth Hospital of Xian from January 2011 to May 2014 were selected. All patients were given implantable collamer lens implantation， followed up for 3 months. The naked eye eyesight， best corrected visual acuity， intraocular pressure， slit-lamp examination， fundus examination， high arch of artificial crystal were observed. Results 1 day to 3 months after surgery， all patients naked eye eyesight achieved or exceeded the preoperative best corrected vision. 1 day after surgery， 13 eyes had intraocular hypertension， IOP ranged from 25-38.8 mmHg. After treatment of local and systemic IOP-lowering medication or anterior chamber puncture， IOP of 10 eyes had returned to normal levels 3 days after surgery， IOP of 2 eyes gradually decreased after stopping using glucocorticoid eye drops at the 7th day after surgery. IOP of 1 patient had bad-controlled 1 month after treatment， given intraocular lens replacement surgery. IOP of all patients returned to normal after 3 months follow-up. 1 month after surgery， ultrasonic biological microscope measure showed that high arch of artificial crystal ranged from 0.5-1.04 mm， artificial lens had not been in contact with the lens itself