原发性青光眼滤过术后发生恶性青光眼的危险因素回顾性分析

Retrospective analysis of risk factors for malignant glaucoma after filtering surgery for primary glaucoma

目的探讨引起原发性青光眼滤过术后发生恶性青光眼的危险因素。方法收集974例原发性青光眼行滤过手术的患者临床资料,其中术后发生恶性青光眼的26例患者(32眼)为恶性青光眼组,以1∶5比例随机抽取130例(163眼)为对照组,回顾性分析患者临床资料,分析结果。结果两组年龄、性别及术前合并症比较差异无统计学意义;恶性青光眼组术前前房深度、术前眼轴长度、晶体厚度短于对照组,术前眼压高于对照组,差异有统计学意义(P<0.05);多因素logistic回归分析结果显示术前眼轴长度是引起患者术后发生恶性青光眼的独立危险因素(P<0.05)。结论原发性青光眼患者术前前房深度、术前眼轴长度、晶体厚度短、术前眼压高时滤过术后容易发生恶性青光眼,尤其是眼轴长度短是患者滤过术后发生恶性青光眼的独立危险因素。

Objective To investigate the risk factors of malignant glaucoma after filtering operation of primary glaucoma.Methods 974 cases of primary glaucoma filtering surgery in patients with clinical data,including 26 cases of malignant glaucoma patients(32 eyes)of malignant glaucoma group,with a ratio of 1∶5,randomly selected 130 cases(163 eyes)as control group,were retrospectively analyzed the clinical data and analysis results.Results The two groups of age,gender and preoperative complications had no significant difference;malignant glaucoma group preoperative anterior chamber depth,preoperative axial length,the crystal thickness is shorter than the control group,preoperative intraocular pressure was higher than the control group,the difference was statistically significant(P<0.05);logistic regression analysis showed that preoperative axial length is an independent risk factor for malignant glaucoma caused by postoperative(P<0.05).Conclusion Primary glaucoma patients with preoperative anterior chamber depth,preoperative axial length,lens thickness,short preoperative intraocular pressure after trabeculectomy is prone to malignant glaucoma,especially short axial length is an independent risk factor for malignant glaucoma filtration surgery.