摘要
目的探讨原发性青光眼滤过术后发生恶性青光眼的危险因素。方法收集我院2008年1月至2013年6月行传统小梁切除术的原发性青光眼患者331例(465眼)的临床资料,按术后是否发生恶性青光眼进行分组,采用A超和UBM分别检测相关参数,包括前房深度、晶状体厚度、眼轴长度及相对晶状体位置(LOWE系数),另对两组年龄、性别及以上相关参数与恶性青光眼发生情况进行单因素及多因素回归分析。结果 331例(465眼)患者中发生恶性青光眼28例(34眼),年龄35~65(48.12±4.56)岁,术前眼压(34.2±6.2)mmHg(1 kPa=7.5 mmHg);未发生恶性青光眼303例(431眼),年龄36~74(59.02±3.12)岁,术前眼压(23.5±3.6)mmHg;发生恶性青光眼组患者较未发生组年龄轻、术前眼压高,差异均有统计学意义(均为P【0.05)。发生青光眼组患者的前房深度、晶状体厚度、眼轴长度及LOWE系数均低于未发生组,但只有晶状体厚度差异有统计学意义(P【0.05)。年龄、术前眼压、眼轴长度单因素分析后的结果均有统计学意义(均为P【0.05);性别、晶状体厚度、前房深度、LOWE系数单因素分析后的结果均无统计学意义(均为P】0.05)。多因素分析结果显示,年龄、眼轴长度是术后并发恶性青光眼的独立危险因素(均为P【0.05)。结论原发性青光眼患者小梁切除术后发生恶性青光眼与患者自身解剖结构有关,年龄较轻、眼轴较短的患者更易发生。
Objective To explore the risk factors of malignant glaucoma occurrence after filtration surgery for primary glaucoma.Methods The clinical data of 331 patients(465 eyes)with primary glaucoma underwent traditional trabeculectomy from January 2008 to June 2013 in our hospital were collected and according to malignant glaucoma happen or not, the groups were divided.A ultrasound and UBM were used to detect the related parameters, including anterior chamber thickness,lens thickness,axis length and relative lens position(LOWE coefficient)and the single factor analysis and multifactor comprehensive Logistic regression analysis were performed to summarize the correlation of above parameters with malignant glaucoma.Results In 331 cases(465 eyes)malignant glaucoma happened in 28 cases(34 eyes)aged 35-65(48.12±4.56)years the preoperative intraocular pressure was(34.2±6.2)mmHg(1 kPa=7.5 mmHg);The cases without malignant glaucoma(303 cases,431 eyes)aged 36-74(59.02±3.12)years,their preoperative intraocular pressure was(23.5±3.6)mmHg,the age was younger and the intraocular pressure was higher than those with malignant glaucoma,there were statistical differences(all P<0.05).The anterior chamber thickness,lens thickness,axis length and LO W E coefficient in patients with malignant glaucoma were lower than those without malignant glaucoma,but there was statistical difference only in lens thickness(P<0.05).The single factor analysis showed there were statistical difference in age preoperative intraocular pressure and axis length(all P<0.05)no statistical difference in gender,lens thickness, anterior chamber thickness and LOWE coefficient(all P>0.05).The multifactor comprehensive Logistic regression analysis showed the age and lens thickness were the risk factors for malignant glaucoma occurrence after filtration surgery for primary glaucoma(all P <0.05).Conclusion The occurrence of malignant glaucoma in patients with primary glaucoma after trabeculectomy is related with its anatomical structure,the young cases with short axis have more liability.
出处
《眼科新进展》
CAS
北大核心
2013年第12期1174-1176,共3页
Recent Advances in Ophthalmology
