云南省高海拔农村多民族聚居区年龄相关性白内障危险因素调查

目的 调查云南省贡山县高海拔农村多民族聚居区40岁及以上人群年龄相关性白内障的危险因素.方法 以云南省贡山县40岁及以上常住居民为研究对象.收集数据包括人口学资料、全身及眼病史、身高、体质量、职业、日照时间、高血压、家庭年收入及全面的眼部检查.晶状体混浊程度依据LOCSⅢ进行分类和定义.将收集数据进行年龄相关性白内障的相关因素分析.结果 1116人(应答率90.3％)接受了全面眼病检查及问卷调查.单因素分析显示年龄、文化程度、体质量指数、日照时间、家庭收入、高血压及傈僳族与年龄相关性白内障发生有关;多因素分析显示年龄是年龄相关性白内障的危险因素,年龄、职业和高血压是核性白内障的危险因素,年龄、职业和家庭经济收入是后囊下白内障的危险因素.结论 多种危险因素与白内障患病率相关,通过改善体力劳动者的工作环境,增加经济收入(提高生活水平)等公共卫生干预,以期预防和降低该地区白内障的发生和发展.     

南昌市社区糖尿病视网膜病变患病率及危险因素分析

目的　调查南昌市部分社区４０岁及以上人群中２型糖尿病患者糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＤＲ）的患病率和相关危险因素。方法　采用分层整群随机抽样的方法对４０岁及以上人群进行问卷调查,并进行身体质量指数、血压、血脂、２４ｈ尿蛋白等检测,同时行眼科相关检查:视力、裂隙灯、验光、眼压、直接眼底镜、眼底照相及荧光眼底血管造影,分析ＤＲ相关危险因素。结果　有９７７６名调查对象接受检查,受检率９７．７６％,８３１例确诊为２型糖尿病,其中有７８０人接受了眼科检查,除５０例屈光介质混浊较重无法看清眼底者外,７３０例患者中确诊ＤＲ者２２３例,占糖尿病患者的３０．５％,其中背景型ＤＲ患者２１１例,占糖尿病患者的２８．９％,增殖型ＤＲ患者１２例,占糖尿病患者的１．６％。多因素分析显示糖尿病病程长、高血糖、高血压、高血脂、高２４ｈ尿微量蛋白是ＤＲ的显著危险因素,而年龄、性别等与ＤＲ发病相关性不大。结论　南昌市社区４０岁及以上人群２型糖尿病患者中ＤＲ的患病率较高,糖尿病病程长、高血压、高血糖、高血脂、高２４ｈ尿微量蛋白是ＤＲ发生的危险因素。     

印度南部2型糖尿病患者糖尿病视网膜病变相关危险因素的研究

目的:探究2型糖尿病患者糖尿病视网膜病变(DR)的严重度及受试者中糖尿病视网膜病变严重程度与其病程、糖化血红蛋白水平、高血压史、年龄和性别的相关性.方法:横断面研究.2012-05/06,采取简单随机抽样方法进行结构化问卷调查,收集100例年龄≥35岁糖尿病视网膜病变患者.进行描述性统计、单变量和多变量有序逻辑回归分析.用excel表进行数据录入,并用SPSS 21.0进行数据分析(P<0.05).结果:100例患者,平均年龄53.16±10.81 (35~78)岁.通过单因素分析发现,糖尿病视网膜病变严重度与年龄(P<0.01),糖尿病病程(P<0.001),糖化血红蛋白水平(P<0.001),糖尿病家族史(P<0.01),高血压病史(P<0.05),均呈正相关,高密度脂蛋白(HDL)及年龄与DR严重程度无相关性.除年龄因素外,上述所有因素均为影响糖尿病视网膜病变严重度的独立风险因素.结论:研究表明,糖尿病病程、糖化血红蛋白水平、糖尿病家族史、高血压病史以及性别与糖尿病视网膜病变严重程度密切相关.但多因素分析中,年龄、HDL因素与DR严重程度无关.因此,利用现有治疗手段的有效性和及时控制,可以预防和消除视力威胁性疾病,延缓DR的发生.     

白内障术后眼内炎的危险因素分析及预后

目的：探讨白内障术后眼内炎的危险因素及玻璃体切割术治疗术后眼内炎的预后。
　　方法：研究在我院进行白内障手术患者1900例1900眼,根据术后有无发生眼内炎分为感染组与对照组。分析患者各临床指标对白内障术后眼内炎发生的影响,采用单因素检验及多因素Logistic回归分析相关危险因素。另外,对所有眼内炎患者进行玻璃体切割术治疗,观察手术对患者预后的影响。
　　结果：单因素分析显示,年龄、高血压、糖尿病、玻璃体溢出、手术时间、普通手术室内进行手术以及麻醉剂开启后未在规定时间内使用等均是导致白内障术后眼内炎发生的危险因素( P<0.05);多因素Logistic回归分析显示,年龄≥70岁、高血压、糖尿病、玻璃体溢出、手术时间≥10 min、普通手术室进行手术以及麻醉剂开启后未在规定时间内使用均是导致白内障术后眼内炎发生的独立危险因素(P<0.05)。经玻璃体切割术治疗后,患者视力得到明显的提高(P<0.05)。
　　结论：年龄、高血压、糖尿病、玻璃体溢出、手术时间、普通手术室进行手术以及麻醉剂开启后未在规定时间内使用等因素均是导致白内障术后眼内炎发生的危险因素。而通过玻璃体切割术治疗,能够有效改善患者的视力。     

糖尿病眼肌麻痹的相关危险因素分析

目的：研究糖尿病眼肌麻痹发生的相关危险因素。

方法：回顾性分析2008-06/2017-06就诊于青岛市市立医院眼科的糖尿病眼肌麻痹患者120例120眼的临床资料,根据颅神经受累部位分为动眼神经麻痹组(Ⅲ组,66例)、外展神经麻痹组(Ⅵ组,41例)、复合神经麻痹组(Ⅲ+Ⅵ组,13例)。收集所有患者的临床资料并进行统计分析,筛选糖尿病眼肌麻痹的相关危险因素。

结果：年龄、性别、糖尿病病程、糖化血红蛋白(HbA1c)水平、合并糖尿病视网膜病变(DR)和高血压情况与糖尿病眼肌麻痹的发生相关,其中年龄≥45岁,男性,糖尿病病程≥10a,合并DR,HbA1c>7%是糖尿病眼肌麻痹发生的独立危险因素。

结论：糖尿病眼肌麻痹的发生与糖尿病患者的年龄、性别、糖尿病病程、是否合并DR及HbA1c水平相关。     

新疆乌苏市糖尿病患者视网膜病变的患病率及危险因素

目的：：了解糖尿病患者糖尿病性视网膜病变( diabetic retinopathy,DR)的患病率及危险因素。方法：对已经确诊的3465例糖尿病患者进行系统的眼部检查,并对相关因素如患者的年龄、性别、居住地域、民族、糖尿病病程、空腹血糖、血脂及血压进行统计分析。结果：本组3465例糖尿病患者中,发生DR者1079例,患病率为31.14％。患者的居住地域、糖尿病病程、空腹血糖水平、血压与糖尿病人群DR患者病率的差异有统计学意义(P<0.05)。年龄、性别、民族及血脂与DR患病率差异无统计学意义(P>0.05)。结论：农村糖尿病人群DR患病率高于城市人群,DR的主要危险因素是糖尿病病程、血糖控制水平和高血压。     

中国陕西省农村年龄相关性黄斑变性流行病学调查

目的：调查中国陕西省农村≥40岁人群年龄相关性黄斑变性（AMD）的患病率及相关危险因素。 方法：2003-07／12,采用整体随机分层抽样法在陕西省洋县、靖边县及富平县调查8500人,其中≥40岁人群3500人,所有受检人员均进行标准问卷调查及详细的眼科检查。应用直接检眼镜散瞳后检查眼底,根据国际AMD分级系统将AMD分为地图状萎缩性年龄相关黄斑变性（GA）和新生血管性年龄相关性黄斑变性（NV）。 结果：≥40岁人群中有2835人完成了相关检查,受检率为81．00％。此受检人群中AMD总患病率（95％CI）为3．00％（2．42,3．71）,其中NV患病率为1．45％（1．05,1．98）,GA患病率为1．55％（1．14,2．10）。通过多因素logistic回归分析显示AMD患病率随着年龄的增长而显著增加（P〈0．001）。在年龄组时AMD患病率为0．47％,80-年龄组时AMD患病率上升至11．90％。NV患病率从40～49年龄组的0．28％上升至80-年龄组的4．76％,GA患病率从40～49年龄组的0．19％上升至80-年龄组的7．14％。各类型AMD患病率在性别上均未见显著差异。在此人群中除年龄为AMD的危险因素外,吸烟也是各类型AMD的重要危险因素。 结论：中国陕西省农村≥40岁人群中AMD患病率低于中国国内其他报道。年龄与吸烟是各类型AMD的重要危险因素。     

增生性糖尿病视网膜病变非血糖非病程相关致病危险因素分析

目的分析增生性糖尿病视网膜病变(PDR)非血糖非病程相关致病危险因素。设计比较性病例系列。研究对象连续收集2型糖尿病合并糖尿病视网膜病变(DR)患者191例,其中PDR患者103例,糖尿病病程≥10年的非增生性糖尿病视网膜病变(NPDR)患者88例;平均年龄(63.9±8.0)岁。方法所有患者均接受详细的病史采集,包括2型糖尿病病程、糖尿病家族史,以及糖尿病确诊后的吸烟史、饮酒史、高血压病史;测量身高、体重及空腹血糖;并进行视力、裂隙灯显微镜、间接检眼镜、荧光素眼底血管造影(FFA)等系统眼科检查。根据国际糖尿病视网膜病变严重程度分级标准对所有患者眼底进行分级诊断。采用Logistic回归分析PDR患病危险因素。主要指标性别构成比、年龄、糖尿病发病年龄、体重指数(BMI)、空腹血糖,高血压病史、吸烟史、饮酒史及糖尿病家族史及各危险因素的优势比(OR)值。结果 NPDR组平均糖尿病病程(15.6±4.9)年较PDR组(12.9±6.6)年长(P=0.002),两组患者平均空腹血糖分别为(7.6±2.1)mmol/L和(7.5±1.6)mmol/L(P=0.78);PDR患者中男性所占比例(53/103)较NPDR患者(30/88)高(P=0.016);PDR患者年龄和糖尿病发病年龄(55.6±9.0岁和42.9±8.4岁)均较NPDR组(63.9±8.0岁和48.3±8.1岁)小(P=0.000)。PDR组和NPDR组间BMI、高血压病史、吸烟史、饮酒史及DM家族史差异均无显著性意义。Logistic回归分析显示,矫正了血糖和病程等相关因素后,性别(男性,OR:2.048)和年龄(低龄,OR:1.126)与PDR患病有关。结论控制血糖及糖尿病病程对PDR发病的影响后,男性及低龄是PDR的致病危险因素。     

南通市区患者初诊糖尿病视网膜病变严重程度的相关因素分析

目的 分析影响南通市区糖尿病性视网膜病变(DR)患者病情程度的相关因素.方法 对南通市区初诊眼底的糖尿病患者200人进行相关问卷调查,问卷主要包括年龄、性别、家族史、糖尿病病程和治疗方式、高血压病程、文化程度、症状出现时间、既往眼病史、诊疗史等方面内容.完善眼底各项检查,记录分析与初诊病情严重程度可能相关的危险因素.结果 确诊DR患者174例.糖尿病病程与DR严重程度具有相关性(x2=87.466,P＜0.01).高血压病程的长短与DR严重程度具有相关性(x2=56.761,P＜0.01).文化程度与DR严重程度具有相关性(x2 =50.712,P＜0.01).症状出现与初就诊的间隔时间,与DR严重程度也具有相关性(x2 =364.044,P=0.032).结论 糖尿病病程、高血压病程、文化程度、症状出现的时间均影响DR患者的病情程度.提高全民文化水平,加强糖尿病眼病知识宣传,将有助于疾病的早期诊断和治疗.     

北京市顺义区40岁及以上人群糖尿病视网膜病变的流行病学调查

背景糖尿病视网膜病变（DR）发病早期隐匿,为DR的早期干预带来了一定的困难。了解人群中DR的发生和进展状况对于中国DR的防治具有重要意义。目的调查北京市顺义区≥40岁的2型糖尿病（DM）患者中DR患病率,探讨DR发生的影响因素。方法采用整群随机抽样方法在顺义区共抽取24个调查点,对≥40岁人群进行问卷调查,并进行身高、体重、血压、血糖测量以及裂隙灯、检眼镜及免散瞳眼底照相等眼部检查。将所得数据进行t检验、X^2检验及Logistic回归分析,评价与DR相关的影响因素。结果抽样所得≥40岁人群4549位中,共有4167（91．6％）位受检者接受筛查。根据早期治疗DR研究组（ETDRS）诊断标准,DR患病率为29．2％,严重的非增生型糖尿病视网膜病变（PDR）为2．5％（n=11）,PDR为1．3％（n=6）,威胁视力的DR为5．4％（n=24）。2型DM患者中,0．4％（4／445）为社会性盲（VA〈0．1）,6．3％（28／445）为双眼的视力损害（VA〈0．3）。单因素分析显示低体质量指数（BMI）（P=0．022）、胰岛素治疗史（P=0．011）与DR的发生有明显相关。较长的DM病程（P〈0．01）及增高的空腹血糖水平（P〈0．01）是DR发生的独立危险因素。而文化程度的提高是预防DR发生的保护性因素（P=0．031）。结论北京市顺义区≥40岁人群DR患病率低于国外同年龄人群的调查结果,胰岛素治疗史及低BMI是影响DR发生的相关因素,而DM病程及空腹血糖水平是DR发生的独立危险因素。加强相关知识的宣传教育对预防DR的发生至关重要。     

中老年人高血压和糖尿病与年龄相关性白内障的关系

目的：探讨中老年人高血压、糖尿病与年龄相关白内障（age-relatedcataract,ARC）危险性之间的关系。方法：采用以医院为基础的病例对照研究方法。病例由45～85岁的360例因患ARC施行白内障手术摘除的患者组成,对照由同期入住相同医院的360例非白内障患者组成,采取1∶1匹配。采用标准调查表对研究对象进行面对面调查,内容包括人口学特征、生活方式、疾病既往史等,同时对血压、血糖进行测量。应用多因素Logistic回归分析估计高血压及糖尿病与ARC关联的比值比（OR）及其相应的95%可信区间（CI）。结果：在调整了年龄和性别因素后,高血压与ARC呈显著正相关（OR=1.573,P=0.005）。与收缩压正常者相比较,收缩压≥180mmHg者发病的危险性增加（OR=2.812,95%CI：1.450～5.455,P=0.002）。高血压病程10a～的研究对象发病的危险性显著地高于病程〈10a者（OR=1.867,95%CI：1.053～3.307,P=0.033）。同样,与非糖尿病患者相比,糖尿病患者发生ARC的危险性显著升高（OR=2.151,95%CI：1.470～3.149,P〈0.001）。与非糖尿病患者相比,糖尿病病程〈10a和10～19a者发生ARC的OR分别为2.374（95%CI：1.502～3.752,P〈0.001）和2.683（95%CI：1.267～5.683,P=0.010）。结论：ARC患病率增高与高血压、糖尿病及其病程增加有关。对这些可变危险因素采取干预性措施,尤其是对高危人群,可能意味着对ARC导致的视觉障碍必须采取控制性措施,因为此症是全球致盲的首要原因。     

Female reproductive factors and eye disease in a rural South Indian population: the Aravind Comprehensive Eye Survey

PURPOSE: To determine the potential associations of female reproductive factors with age-related cataract, open-angle glaucoma, macular degeneration, and myopia in an older population of rural south India. METHODS: This was a population-based, cross-sectional study of older adults in rural south India identified through a cluster sampling technique. Histories relating to female reproductive factors were ascertained through a questionnaire administered by trained workers. Detailed ocular examinations including automated perimetry were performed on all participants at a base hospital to arrive at a diagnosis of ocular morbidity. RESULTS: The study achieved a high response rate (93.0%), with examinations performed on 5150 of the eligible 5539 persons aged 40 years or more. Age at menarche was available for 2797 (98.6%) of the women and age at natural menopause for 1841 (98.0%) of 1878 women who were postmenopausal. The mean age at menarche was 14.8 +/- 1.8 years, and the mean age at menopause was 43.4 +/- 3.9 years. The mean duration of endogenous estrogen exposure was 28.4 +/- 4.3 years. The median number of pregnancies was 4 (mean, 4.3 +/- 2.6; range, 0-16). Older age at menarche (>or=14 years) was associated with reduced risk for age-related cataract and myopia, and greater risk for macular degeneration. Neither age at menopause nor duration of endogenous estrogen exposure was associated with any of the ocular diseases studied. Parity was not associated with any of the ocular diseases studied in a multivariate model. CONCLUSIONS: Female reproductive factors do not appear to influence age-related cataract, open-angle glaucoma, macular degeneration or myopia significantly in rural south India.     

The epidemiology of cataract in Australia

PURPOSE: To describe the prevalence and risk factors for cataract in an Australian population aged 40 years and older. METHODS: Participants were recruited by a household census and stratified, random cluster sampling to represent residents of Victoria, Australia, aged 40 years and older. The following information was collected: initial visual acuity and best-corrected visual acuity, demographic details, health history, dietary intake of antioxidants, lifetime ocular ultraviolet B exposure, and clinical eye examination, including lens photography. Cortical opacities were measured in sixteenths. Cortical cataract was defined as opacity greater than or equal to 4/16 of pupil circumference. Nuclear opacities were graded according to the Wilmer cataract grading scheme, and cataract was defined as greater than or equal to nuclear standard 2.0 of four standards. The height and width of any posterior subcapsular opacity was measured and recorded. Posterior subcapsular cataract was defined as posterior subcapsular opacity greater than or equal to 1 mm2. The worse eye was selected for analysis. Backward stepwise logistic regression was used to quantify independent risk factors for cataract. RESULTS: A total of 3,271 (83% of eligible) of the urban residents, 403 (90% of eligible) nursing home residents, and 1,473 (92% of eligible) rural residents participated. The urban residents ranged in age from 40 to 98 years (mean, 59 years), and 1,511 (46%) were men. The nursing home residents ranged in age from 46 to 101 years (mean, 82 years), and 85 (21%) were men. The rural residents ranged in age from 40 to 103 years (mean, 60 years), and 701 (47.5%) were men. The overall weighted rate of cortical cataract was 11.3% (95% confidence limits, 9.68%, 13.0%) excluding cataract surgery and 12.1% (95% confidence limits, 10.5%, 13.8%) including cataract surgery. The risk factors for cortical cataract that remained in the multivariate logistic regression model were age, female gender, diabetes duration greater than 5 years, gout duration greater than 10 years, arthritis diagnosis, myopia, use of oral beta-blockers, and increased average annual ocular ultraviolet B exposure. Overall, 12.6% (95% confidence limits, 9.61%, 15.7%) of Victorians aged 40 years and older had nuclear cataract including previous cataract surgery, and 11.6% (95% confidence limits, 8.61%, 14.7%) had nuclear cataract excluding previous cataract surgery. In the urban and rural cohorts, age, female gender, rural residence, brown irides, diabetes diagnosed 5 or more years earlier, myopia, age-related maculopathy, having smoked for greater than 30 years, and an interaction between ocular ultraviolet B exposure and vitamin E were all risk factors for nuclear cataract. The rate of posterior subcapsular cataract excluding previous cataract surgery was 4.08% (95% confidence limits, 3.01%, 5.14%), whereas the overall rate of posterior subcapsular cataract including previous cataract surgery was 4.93% (95% confidence limits, 3.68%, 6.17%) . The independent risk factors for posterior subcapsular cataract in the urban and rural cohorts that remained were age in years, rural location, use of thiazide diuretics, vitamin E intake, and myopia. CONCLUSIONS: The expected increase in the prevalence of cataract with the aging of the population highlights the need to plan appropriate medical services and public health interventions for primary and secondary prevention. Many of the identified risk factors for cataract in the population have the potential for being modified through public health interventions.     

Attributable risk estimates for cataract to prioritize medical and public health action

PURPOSE: Cataract is the most common cause of blindness in the world. The purpose of this study was to estimate the population attributable risk associated with identified risk factors for cortical, nuclear, and posterior subcapsular (PSC) cataract in a representative sample of the Victorian population aged 40 years and older. METHODS: Cluster, stratified sampling was used and participants were recruited through a household census. At locally established test sites, standardized clinical examinations were performed to assess cataract and personal interviews were conducted to quantify potential risk factors. Multivariate logistic regression was used to determine the independent risk factors associated with the three types of cataract, and the population attributable risk was calculated. RESULTS: A total of 3271 (83% of eligible) of the urban residents and 1473 (92%) rural residents participated. The urban residents ranged in age from 40 to 98 years (mean, 59 years), and 1511 (46%) were men. The rural residents ranged in age from 40 to 103 years (mean, 60 years), and 701 (48%) were men. The overall prevalence of cortical cataract was 12.1% (95% CL 10.5, 13.8), nuclear cataract 12.6% (95% CL 9.61, 15.7), and PSC cataract 4.93% (95% CL 3.68, 6.17). Significant risk factors for cortical cataract included age, female gender, diabetes for greater than 5 years, gout for greater than 20 years, arthritis, myopia, average annual ocular UV-B exposure, and family history of cataract (parents or siblings). Significant risk factors for nuclear cataract included age, female gender, rural residence, age-related maculopathy, diabetes for greater than 5 years, smoker for greater than 30 years, and myopia. The significant risk factors for PSC cataract were age, rural residence, thiazide diuretic use, and myopia. Of the modifiable risk factors, ocular UV-B exposure explains 10% of the cortical cataract in the community, and cigarette smoking accounts for 17% of the nuclear cataract. CONCLUSIONS: Because of the near universal exposure to UV-B in the environment, ocular protection has one of the highest modifiable attributable risks for cortical cataract and would therefore be an ideal target for public health intervention. Quit smoking campaigns can be expanded to incorporate information about the excess cataract in the community associated with long-term smoking. Nonmodifiable risk factors such as age, gender, and long-term medication use have implications for the timely referral and treatment for those at higher risk of cataract.     

Risk factors for cataract: a case control study

The present study was designed as a hospital-based, group-matched, case-control investigation into the risk factors associated with age-related cataract in central India. The study included 262 cases of age-related cataract and an equal number of controls. A total of 21 risk factors were evaluated: namely, low socioeconomic status (SES), illiteracy, marital status, history of diarrhoea, history of diabetes, glaucoma, use of cholinesterase inhibitors, steroids, spironolactone, nifedipine, analgesics, myopia early in life, renal failure, heavy smoking, heavy alcohol consumption, hypertension, low body mass index (BMI), use of cheaper cooking fuel, working in direct sunlight, family history of cataract, and occupational exposure. In univariate analysis, except marital status, low BMI, renal failure, use of steroids, spironolactone, analgesics, and occupational exposure, all 14 other risk factors were found significantly associated with age-related cataract. Unconditional multiple logistic regression analysis confirmed the significance of low SES, illiteracy, history of diarrhoea, diabetes, glaucoma, myopia, smoking, hypertension and cheap cooking fuel. The etiological role of these risk factors in the outcome of cataract is confirmed by the estimates of attributable risk proportion. The estimates of population attributable risk proportion for these factors highlight the impact of elimination of these risk factors on the reduction of cataract in this population.     

普通眼科门诊青光眼认知度的调查

目的提高公众对青光眼的认知度及青光眼患者的检出率。方法采用问卷随机抽样调查646例普通眼科门诊就诊者。所有数据用χ^2检验和多因素logistic回归分析处理数据。结果66.6%的受访者表示对青光眼不了解,其中51.61%为已确诊的青光眼患者。青光眼的认知与性别、服用糖皮质激素史、高血压、糖尿病以及近视均无相关性（P〉0.05）,与年龄、教育程度、具有卫生部门工作经历、定期眼科检查、曾经接受散瞳检查、具有青光眼家族史等显著相关。心血管患者及服用降血压药物的受访者对青光眼的认知度高于其他人群。结论青光眼认知度问卷调查为青光眼患者的宣教和知识普及提供了目标人群,使早期防治有所提示。近视患者、糖皮质激素服用者、高龄人群、低教育程度者、糖尿病及高血压患者、无定期眼科保健者以及部分对青光眼缺乏认识的青光眼患者,是今后加强宣教的目标人群。     

晶状体溶解性青光眼患者白内障手术后高眼压的危险因素

目的：探讨晶状体溶解性青光眼(PLG)患者白内障手术术后高眼压的危险因素。

方法：回顾性分析。2010-01/2020-12我院148例148眼行白内障手术治疗的PLG患者的临床资料,根据其术后高眼压发生情况分为非高眼压组(126例)与高眼压组(22例)。采用Logistic回归分析评估PLG患者白内障手术术后高眼压的危险因素。构建列线图预测模型,并绘制受试者工作特征曲线(ROC)评估列线图模型的预测能力。

结果：两组患者年龄、性别、BMI、白内障晶状体核分级、合并高血压及手术方式均无差异(P>0.05); 高眼压组患者合并糖尿病、高度近视、术前合并色素膜炎、术前合并眼外伤及术中并发症占比均高于非高眼压组(P<0.05)。Logistic回归分析显示,合并糖尿病、高度近视、术前合并色素膜炎、术前合并眼外伤及术中并发症是PLG患者白内障手术术后高眼压的影响因素。本研究构建的列线图模型拟合效果良好,其ROC曲线下面积为0.906(0.890～0.921),表明具有较强的预测能力。

结论：术中并发症、术前合并色素膜炎、合并眼外伤、合并糖尿病及高度近视的PLG患者白内障手术后发生高眼压的风险较高,临床应对这些患者予以重视,以期改善患者的预后。     

The natural history of glaucoma and ocular hypertension after pediatric cataract surgery.

INTRODUCTION: We sought to define the prevalence and natural history of ocular hypertension and glaucoma for at least a 10-year period after pediatric cataract surgery. METHODS: We conducted a prospective observational study of patients who received pediatric cataract surgery. Inclusion criteria included 2 directed ophthalmologic examinations performed at a minimum of 5 and 10 years after surgery. RESULTS: A total of 63 patients (22 with bilateral cataracts and 41 with unilateral cataracts) were examined at a median of 15.1 year (range, 10.3-21.3 years) after surgery. A majority of the subjects had glaucoma or ocular hypertension (ie, 59%; 37/63). Nineteen percent (12/63) had glaucoma (5/22 with bilateral cataracts and 7/41 with unilateral cataracts). Approximately half (7/12) had developed glaucoma during the first 5-year observational period and the remainder (5/12) developed it during the following observational period. Forty percent (25/63) of the patients had ocular hypertension in at least one aphakic eye (9/23 with bilateral cataracts and 16/40 with unilateral cataracts). The rate of progression from ocular hypertension to glaucoma over a mean observational period of 7.2 years (range, 6.2-8.1 years) was 23% (5/22). DISCUSSION: Patients who receive surgery for pediatric cataracts are at very high risk of developing ocular hypertension and glaucoma. Patients can develop late-onset glaucoma and ocular hypertension more than 10 years after surgery. Years of ocular hypertension may precede the diagnosis of late-onset glaucoma.     

Risk factors for vitreous loss in cataract surgery

PURPOSE: To evaluate the risk factors for posterior capsule rupture with or without vitreous loss (PCR +/- VL) in extracapsular cataract extraction (ECCE). METHODS: The charts of 2794 consecutive patients who had ECCE with or without intraocular lens implantation between January 1992 and December 1997 were reviewed retrospectively. Probable risk factors included age, sex, operated eye (right or left), presence of diabetes mellitus, systemic hypertension, history of vitreous loss in the other eye (if operated), type of cataract, axial length of the eye, preoperative visual acuity, glaucoma, presence of pseudoexfoliation, preoperative shallow anterior chamber and experience of surgeon (resident, general ophthalmologist, cataract surgeon). We compared 192 patients who had PCR +/- VL with complete data and 275 randomly selected patients who had no complications, using multiple logistic regression analysis. RESULTS: Two hundred and fifty-four patients (9.09%) had PCR and 197 (7.05%) had PCR + VL. The surgeon's experience (p < 0.0005), glaucoma (p < 0.005), type of cataract (p < 0.005), presence of pseudoexfoliation (p < 0.05) and systemic hypertension (p < 0.05) were significant risk factors. CONCLUSIONS: Patients with risk factors such as glaucoma, pseudoexfoliation, traumatic cataract and systemic hypertension should be operated by experienced surgeons.