792例白内障手术患者术后激素性高眼压的危险因素分析

Risk factors of postoperatve hormone-induced intraocular hypertension in 792 patients with cataract surgery

目的探讨白内障手术患者术后激素性高眼压的危险因素。方法回顾性分析792例(792眼)行白内障超声乳化联合人工晶状体植入术治疗患者的临床资料,根据其术后激素性高眼压发生情况分为激素性高眼压组与非激素性高眼压组。比较2组性别、年龄、白内障晶体核分级、高度近视、高血压、糖尿病、术前合并青光眼、术前合并色素膜炎、术前合并眼外伤、术中并发症等情况差异,并采用多因素Logistic回归分析评估白内障超声乳化联合人工晶状体植入术后激素性高眼压的危险因素。结果792例患者出现激素性高眼压者29例(3.66%),纳入激素性高眼压组;未出现激素性高眼压者763例(96.34%),纳入非激素性高眼压组。2组性别、白内障晶体核分级、高血压、术前合并青光眼情况比较,差异无统计学意义(P>0.05);激素性高眼压组患者年龄显著小于非激素性高眼压组(P<0.01),高度近视、糖尿病、术前合并色素膜炎、术前合并眼外伤及术中并发症的发生率均显著高于非激素性高眼压组(P<0.05或P<0.01)。经Logistic回归分析,发现高龄是影响白内障超声乳化联合人工晶状体植入术后激素性高眼压的独立保护因素(OR=0.660,P<0.05),而高度近视、糖尿病、术前合并色素膜炎、术前合并眼外伤及术中并发症是其独立危险因素(OR=1.893、1.669、2.487、2.069、2.568,P<0.05或P<0.01)。结论年龄较小及合并高度近视、糖尿病、色素膜炎、眼外伤、术中并发症的白内障手术患者易发生术后激素性高眼压,临床应予以针对性防控措施,以改善白内障患者的预后。

Objective To analyze the risk factors of postoperative hormone-induced intraocular hypertension in patients with cataract surgery.Methods A retrospective analysis was performed on clinical data of 792 cases(792 eyes)who underwent phacoemulsification combined with intraocular lens implantation in our hospital.According to the occurrence of postoperative hormone-induced intraocular hypertension,they were divided into hormone-induced intraocular hypertension group and non-hormone-induced intraocular hypertension group.The gender,age,cataract crystal nucleus classification,high myopia,hypertension,diabetes mellitus,preoperative complicating with glaucoma,preoperative complicating with uveitis,preoperative ocular trauma and intraoperative complications were compared between the two groups.Multivariate Logistic regression analysis was used to evaluate the risk factors for steroid-induced intraocular hypertension after phacoemulsification and intraocular lens implantation.Results Out of 792 patients,29 cases(3.66%)with hormone-induced intraocular hypertension were included in hormone-induced intraocular hypertension group,and 763 cases(96.34%)without hormone-induced intraocular hypertension were included in non-hormone-induced intraocular hypertension group.There were no significant differences in the gender,cataract crystal nucleus classification,hypertension,preoperative complicating with glaucoma between the two groups(P>0.05).The age in hormone-induced intraocular hypertension group was lower than that in non-hormone-induced intraocular hypertension group(P<0.05),and the incidence of high myopia,diabetes mellitus,preoperative complicating with uveitis,preoperative complicating with ocular trauma and intraoperative complications in hormone-induced intraocular hypertension group were higher than those in non-hormone-induced intraocular hypertension group(P<0.05 or P<0.01).Logistic regression analysis showed that elder age was an independent protective factor affecting hormone-induced intraocular hypertension group after phacoemulsification combined with intraocular lens implantation(OR=0.660,P<0.05),and high myopia,diabetes mellitus,preoperative complicating with uveitis,preoperative complicating with ocular trauma and intraoperative complications were independent risk factors(OR=1.893,1.669,2.487,2.069,2.568,P<0.05 or P<0.01).Conclusion The young patients with cataract surgery and those with high myopia,diabetes mellitus,uveitis,ocular trauma and intraoperative complications are prone to occurring postoperative hormone-induced intraocular hypertension.Clinically,targeted prevention and control measures should be taken to improve the prognosis of cataract patients.