关键词: 玻璃体切除, 高眼压, 硅油, 视网膜脱离

Abstract: Objective To investigate the incident rate and risk factors of intraocular pressure(IOP) elevation within 3 days afterpars plana vitrectomy and silicone oil tamponade for retinal detachment. Design Prospective case series. Participants 135 cases of retinal detachment patients who were treated by vitrectomy with silicone oil tamponade from February to August 2018 in Peking University Third Hospital were consecutively included. Methods IOP at hours 2, 4, 6~8, and days 1, 2, 3 after surgery were recorded. IOP≥25 mmHg at any time was defined as IOP elevation. Survival time was defined as the time interval (hours) from the end of vitrectomy to the onset of the first IOP elevation. Cox regression analysis was used to evaluate the risk factors associated with postoperative IOP elevation. Kaplan-Meier survival curves were constructed to visualize the probability of overall survival of patients with different etiology of retinal detachment. Main Outcome Measures Incidence and risk factors for IOP elevation. Results Among 135 patients enrolled, 44 (32.6%) patients developed IOP elevation, with the incident rate peaked at the postoperative day one (20.2%). The etiology of retinal detachment was significantly associated with the IOP elevation (P=0.006). Compared to primary rhegmatogenous retinal detachment, patients with diabetic tractional retinal detachment and recurrent retinal detachment had 3.5 (P=0.002, hazards ratio (HR) =3.41) and 3 (P=0.010, HR=2.91) folds of increased risk for IOP elevation. The overall survival probability of diabetic traction retinal detachment and recurrent retinal detachment was significantly lower than that of primary rhegmatogenous retinal detachment and traumatic retinal detachment (all P<0.05). Conclusion Early-onset IOP elevation occurs in one-third of retinal detachment eyes with silicone oil tamponade, with the incidence peaked at the first postoperative day. The first postoperative day visit, at least IOP examination, is still necessary for eyes underwent vitrectomy and silicone oil tamponade, especially those with diabetic tractional retinal detachment and recurrent retinal detachment. (Ophthalmol CHN, 2022, 31: 27-32)

Key words:  pars plana vitrectomy, intraocular pressure, silicone oil, retinal detachment