原发性闭角型青光眼患者超声乳化联合房角分离术后发生恶性青光眼的影响因素

Influencing Factors of Malignant Glaucoma After Phacoemulsification Combined with Goniosynechialysis in Patients with PACG

目的探讨原发性闭角型青光眼(PACG)超声乳化联合房角分离术(Phaco+GSL)后发生恶性青光眼(MG)的影响因素。方法选取2019年11月至2020年11月淅川县人民医院行Phaco+GSL后发生MG的50例PACG患者作为发生组,另收集同期行Phaco+GSL后未发生MG的50例PACG患者作为未发生组。查阅资料并收集相关指标,经单因素与多因素分析PACG患者Phaco+GSL后发生MG的影响因素。结果发生组女性占比、年龄、眼轴长度(AL)、晶状体厚度(LT)均低于未发生组,术前眼压(IOP)高于未发生组(P<0.05);组间其他基线资料比较,差异无统计学意义(P>0.05)。多因素分析结果显示,女性、年龄较小、AL及LT值较低、术前IOP较高均是PACG患者Phaco+GSL后发生MG的影响因素(OR>1,P<0.05)。结论女性、年龄较小、AL及LT值较低、术前IOP较高均是PACG患者Phaco+GSL后发生MG的影响因素。临床工作者可针对性进行干预(如加强监测、术前控制眼压等),以降低MG的发生率。

Objective To investigate the influencing factors of malignant glaucoma(MG)after phacoemulsification combined with goniosynechialysis(Phaco+GSL)in primary angle closure glaucoma(PACG).Methods A retrospective analysis was conducted,and the clinical data of 50 PACG patients who had MG after Phaco+GSL in Xichuan County People’s Hospital of Henan Province from November 2019 to November 2020 were set as occurrence group.In addition,the clinical data of 50 PACG patients who did not develop MG after Phaco+GSL in Xichuan County People’s Hospital during the same period were collected and set as non-occurrence group.The data were consulted and the related data of medical data were collected.By univariate and multivariate analysis,the influencing factors of MG in patients with PACG after Phaco+GSL were analyzed.Results The proportion of female,age,axial length(AL)and lens thickness(LT)in occurrence group were lower than those in non-occurrence group,and the preoperative intraocular pressure(IOP)was higher than that in non-occurrence group(P<0.05).There was no statistical difference in other baseline data between the two groups(P>0.05).Multivariate analysis showed that female,younger age,lower values of AL and LT and higher preoperative IOP were the influencing factors of MG in PACG patients after Phaco+GSL(OR>1,P<0.05).Conclusion Female,younger age,lower AL and LT values and higher preoperative IOP are the influencing factors of MG in PACG patients after Phaco+GSL.Clinical workers can carry out targeted interventions(such as strengthening monitoring,preoperative intraocular pressure control,etc.)to reduce the incidence of MG.