方法：于我院行23G玻切联合C₃F₈注入的高度近视性黄斑裂孔不伴视网膜脱离患者188例205眼； 监测术后1wk内的眼压。当眼压介于22～29mmHg时设为A组，随机加用盐酸卡替洛尔滴眼液(A1组)或拉坦前列素滴眼液(A2组)； 当介于30～39mmHg时设为B组，随机加用盐酸卡替洛尔滴眼液+酒石酸溴莫尼定滴眼液(B1组)或盐酸卡替洛尔滴眼液+拉坦前列腺素滴眼液(B2组)； 当高及40mmHg及以上时，设为C组，20%甘露醇快速静脉滴注1次，并随机加用盐酸卡替洛尔滴眼液+酒石酸溴莫尼定滴眼液+布林佐胺滴眼液(C1组)或盐酸卡替洛尔滴眼液+酒石酸溴莫尼定滴眼液+拉坦前列腺素滴眼液(C2组)。连续观察3d，眼压降至21mmHg及以下时则视为有效，比较不同用药3d内的降压有效率、降压幅度及平均有效作用时间。

结果：符合研究标准的术后高眼压共89眼，发生于前3d共70眼(78.6%)。A组共31眼，A1组14眼，A2组17眼； 有效例数分别为5例(35.7%)、13例(76.5%)，差异有统计学意义(χ²=5.24，P=0.03)； 降压幅度分别为4.21±1.22mmHg(24%)、8.76±3.03mmHg(29.6%)，差异有统计学意义(t=5.73，P<0.05)； 平均有效作用时间分别为2.80±0.45、2.08±0.49d，差异有统计学意义(t=2.85，P=0.012)。B组共32眼，B1组17眼，B2组15眼，有效例数分别为9例(52.9%)、11例(73.3%)，差异无统计学意义(χ²=1.40，P=0.30)； 降压幅度分别为10.59±2.72mmHg(36.9%)、16.53±2.67mmHg(43.8%)，差异有统计学意义(t=6.27，P<0.05)； 平均有效作用时间分别为2.56±0.53、1.63±0.67d，差异有统计学意义(t=3.34，P=0.004)。C组共26眼，C1组14眼，C2组12眼，有效例数分别为9例(64.3%)、8例(66. 7%)，差异无统计学意义(P=0.70)； 降压幅度分别为22.00mmHg(51.0%)、31.45mmHg(59.3%)，差异有统计学意义(t=18.35，P<0.05)； 平均有效作用时间分别为2.63±0.52、1.80±0.63d，差异有统计学意义(t=2.97，P=0.009)。

结论：高度近视性黄斑裂孔玻璃体切割术后伴发高眼压的比率较高，一般发生在术后3d内，单独或联合应用拉坦前列素滴眼液可以有效降低眼压。

METHODS:One hundred and eighty-eight cases(205 eyes)suffered from macular hole caused by high myopia without reinal detachment who underwent PPV combined with C₃F₈ tamponade were studied retrospectively and measured the IOP at 1wk after surgeries. The patients whose IOP was 22～29mmHg were named as group A. Then they were divided randomly into two subgroups, group A1(treated by carteolol eye drops)and subgroup A2(treated by latanoprost eye drops). The patients whose IOP was 30～39mmHg were named as group B. Then they were divided randomly into two subgroups, group B1(treated by both carteolol and brimonidine tartrate eye drops)and subgroup B2(treated by both latanoprost and carteolol eye drops). The patients whose IOP was ≥40mmHg were named as group C and they were all treated by rapid intravenous injection of 20% Mannitol. Meanwhile, they were divided randomly into two subgroups, group C1(treated by carteolol,brimonidine tartrate and brinzolamide eye drops )and subgroup C2(treated by carteolol,brimonidine tartrate and latanoprost eye drops). Continuous observation lasted 3d. If IOP dropped to below 21 mmHg, we considered it valid. And then,compare the effectiveness, IOP reduction and the average effective duration.

RESULTS:Eighty-nine eyes met the criteria of high IOP and IOP of 70 eyes(78.6%)increased within 3d after operations. There were 31 eyes in group A including 14 eyes in group A1 and 17 eyes in group A2.The number of effective cases of the two groups was 5(35.7%)and 13(76.5%)respectively, the difference was statistically significant(χ²=5.24,P=0.03).The IOP reduction of the two groups were 4.21±1.22mmHg(24%), 8.76±3.03mmHg(29.6%), respectively, and the difference was statistically significant(t=5.73,P<0.05).The average effective duration of the two group were 2.80±0.45, 2.08±0.49d,respectively, and the difference was statistically significant(t=2.85,P=0.012).There were 32 eyes in group B including 17 eyes in group B1 and 15 eyes in group B2.The number of effective cases of the two groups was 9(52.9%)and 11(73.3%),respectively, and the difference was not statistically significant(χ²=1.40,P=0.30 ).The IOP reduction of the two groups was 10.59±2.72mmHg(36.9%), 16.53±2.67mmHg(43.8%)respectively, and the difference was statistically significant(t=6.27,P<0.05).The average effctive duration of the two group was 2.56±0.53, 1.63±0.67d respectively, and the difference was statistically significant(t=3.34,P=0.004). There were 26 eyes in group C including 14 eyes in group C1 and 12 eyes in group C2.The number of effective cases of the two groups was 9(64.3%)and 8(66.7%)respectively, and the difference was not statistically significant(P=0.70).The IOP reduction of the two groups was 22.00mmHg(51.0%),31.45mmHg(59.3%)respectively, and the difference was statistically significant(t=18.35,P<0.05).The average effctive duration of the two group was 2.63±0.52, 1.80±0.63d respectively, and the difference was statistically significant(t=2.97,P=0.009).

CONCLUSION:PPV treating macular hole caused by high myopia is associated with highe rates of IOP increasing, which generally occurs within 3d after the operation. Alone or in combination, latanoprost eye drops can effectively reduce IOP.