PACG术后发生恶性青光眼危险因素回顾性分析

Retrospective analysis of risk factors of malignant glaucoma after PACG

目的探讨引起原发性闭角型青光眼(PACG)术后发生恶性青光眼危险因素。方法收集行手术治疗的483例患者(642眼)临床资料,对可能引起术后恶性青光眼发生的因素进行分析。结果术后发生恶性青光眼者14例(24眼),发生率为2.90%(3.74%);年龄<60岁、慢性PACG、房角全关闭、持续高眼压、眼轴长度<22 mm、前房深度<2 mm、晶体厚度<4.5 mm时术后恶性青光眼发生率分别为4.85%、4.79%、5.42%、4.90%、5.51%、5.44%、4.27%,≥60岁、急性PACG、房角非全关闭、高眼压缓解、眼轴长度≥22 mm、前房深度≥2 mm、晶体厚度≥4.5 mm时术后恶性青光眼发生率分别为1.17%、1.09%、1.94%、1.45%、1.01%、1.02%、0.67%,比较差异有统计学意义(P<0.05);Logistic回归分析显示年龄<60岁、房角全关闭、持续高眼压、眼轴长度<22 mm是引起PACG术后发生恶性青光眼的独立危险因素(P<0.05)。结论年龄小、术前房角全关闭、持续高眼压、眼轴长度短是PACG术后发生恶性青光眼危险因素,应在术前予以重视。

Objective To investigate the risk factors of malignant glaucoma after primary angle closure glaucoma(PACG).Methods The clinical data of 483 patients(642 eyes) who underwent surgical treatment were analyzed.The factors that might cause postoperative malignant glaucoma were analyzed.Results 14 cases of malignant glaucoma after surgery(24 eyes),the incidence rate was 2.90%(3.74%); age<60 years,PACG,chronic angle closure and the sustained high intraocular pressure,axial length<22 mm,anterior chamber depth<2 mm,crystal thickness<4.5 mm after resection of malignant glaucoma occurred in 4.85% 4.79%,5.42%,4.90%,5.51%,5.44%,4.27%,≥60 years old,PACG,acute angle-closure,high intraocular pressure relief,the axial length≥22 mm,anterior chamber depth≥2 mm,the crystal thickness≥4.5 mm after resection of malignant glaucoma occurred in 1.17%,1.09%,1.94%,1.45%,1.01%.1.02%,0.67%,the difference was statistically significant(P<0.05); Logistic regression analysis showed that age<60 years,full closed angle,sustained high intraocular pressure,axial length less than 22 mm is an independent risk factor for malignant glaucoma caused by postoperative PACG(P<0.05).Conclusion Small age,complete closure of the anterior chamber angle,sustained high intraocular pressure and short axial length are risk factors for malignant glaucoma after PACG,and should be paid attention to before the operation.