The Clinical Study Of Early High Intraocular Pressure After Vitreoretinal Surgery

Vitreoretinal surgery has played an important role in the treatment area of ophthalmology. With the scientific and technological progress, the ongoing research of scientists, clinicians accumulation of experience, vitreoretinal surgery has been increasingly improved, not only expanded the indications for surgery, intraoperative and postoperative complication rate has been gradually reduced. But the occurrence of complications and treatment are still affecting the visual function recovery as the major factors, pending further review and study. Especially, the incidence and reasons of the postoperative high intraocular pressure caused the attention of domestic and foreign scholars.High IOP following vitreoretinal surgery is a common complication. There are many reasons for its occurrence, multi-factors, such as the acute inflammation, postoperative edema of tissue,the overdose of intraoperative injection of silicone oil and gas, the closure of Ando Kong in no lens eyes, gas expansion, pupillary block, combined scleral buckling surgery, hormone, silicone oil emulsion droplets blocking angle ,etc. According to various possible reasons for high IOP ,we make the appropriate treatment, Actively prevent and control high IOP,and do long-term follow-up. Try to avoid high IOP on visual function damage. This paper studied early high IOP after vitreoretinal surgery.Objective:Through the clinical observations of patients with the early high IOP after vitreoretinal surgery, to explore its incidence, disease factors, time of occurrence, treatment, the effect of treatment. The purpose is to guide the clinical, prevent early postoperative high IOP generation actively, control early postoperative high IOP effectively. So we can avoid visual function loss from the effects of higher IOP.Methods:To random investigate the clinical data of 190 patients (204 eyes) underwent vitreoretinal surgery by the same surgeon, the age of 14 to 83 years old, mean age 52.6 years.The eyes had been taken the routine examination before surgery and standard three-channel by the ciliary body pars Closed vitreoretinal surgery during the operation. According the condition of eyes , the surgeon choose one kind of the three packing material for filling the eyes, which including intraocular irrigating solution, perfluorocarbon gases(concentration of 12% ~ 16%),and silicone oil. Sometimes the eyes had been combined with scleral buckling surgery or surgical removal of lens,together with posterior chamber intraocular lens implantation. Measured intraocular pressure is Tn by finger measurements at the end of surgery. Given anti-inflammatory treatment after surgery. Observe the eyes of patients during hospitalization. High IOP is defined as IOP higher than 25mmHg (Averaged three times)by NCT or T+1 by finger measurements. Patient Complaine of pain in the eye surgery, accompanying headache by ipsilateral. Corneal edema and opacity had been found by observations of slit-lamp.Results:1. In the 204 eyes, the occurrence of early postoperative high IOP is 43, accounting for 21.1%.2. Preoperative group of different diseases: its occurrence is 23, accounting for 28.4%,in the PDR group; its occurrence is 15, accounting for 20.5%,in the retinal detachment group; its occurrence is 2, accounting for 7.7%,in the vitreous hemorrhage group; its occurrence is 3, accounting for 14.3%,in the ocular trauma group; difference was not statistically significant . ( P>0.05)3. Age distribution: in 14 ~ 29 age group,there are 2 (13.3%) had high IOP; in 30 ~ 49 age group, there are 16 (22.5%); in 50 ~ 69 age group, t are 21 (20.4%); in 14 ~ 29 age group, there are 4 (26.7%); in more than 70 age group, There are 4 (26.7%).4. In the 43 eyes having high IOP ,there are 30 eyes occurred in the first three days after surgery,9 eyes in the 4 days to 1 week, 4 eyes in the 1 week later. 14 eyes filled with C3F8 gas occurred within a week. In the 24 eyes filled with silicone oil , 20 eyes occurred within 1 week,4 eyes occurred in the 1 week later.5 Filled with different packing material:3 eyes(5.9﹪)occurred in the intraocular irrigating solution group; 16 eyes(22.5﹪)occurred in the C3F8 gas group; 24 eyes(29.3﹪)occurred in the silicone oil group; the difference was statistically significant in the three group , in the C3F8 gas and silicone oil group .( P<0.05).6. 18eyes(23.7﹪) been combined with scleral buckling surgery occurred high IOP,it is unconspicuous through the statistical test. ( P>0.05). 2 eyes(28.6﹪) been combined with surgical removal of lens occurred high IOP,it is unconspicuous through the statistical test. ( P>0.05).7.We observed when IOP is 25～30 mmHg. Given eye drops of aqueous humor generation inhibitors, IOP is 31～49 mmHg. When IOP is more than 50mmHg , In addition to the above- mentioned treatment, combined with intravenous infusion of 20﹪mannitol.Conclusions:Vitreoretinal surgery after high IOP is the result of multiple factors. Avoiding leading causes of intraocular pressure elevation, reduce intraocular silicone oil and gas filled. Closely monitoring the situation in post-operative IOP, the high early IOP can be detectioned and effectively controlled in the normal range. Protect visual function.