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。

Analysis of risk factors of high intraocular pressure after cataract surgery for phacolytic glaucoma

AIM:To investigate the risk factors of high intraocular pressure after cataract surgery for phacolytic glaucoma(PLG).

METHODS: The clinical data of 148 PLG patients(148 eyes)who underwent cataract surgery were analyzed retrospectively. According to the occurrence of postoperative high intraocular pressure, the patients were divided into non-high intraocular pressure group and high intraocular pressure group. Logistic regression analysis was used to evaluate the risk factors of high intraocular pressure after cataract surgery in PLG patients. Nomogram model was constructed, whose predictive ability was evaluated by receiver operating characteristic curve(ROC).

RESULTS: There was no significant difference in age, gender, BMI, cataract lens nucleus grade, combined with hypertension, and surgical methods between two groups(P>0.05); the proportion of diabetes, high myopia, preoperative uveitis, preoperative ocular trauma and intraoperative complications in high intraocular pressure group were higher than those of non-high intraocular pressure group, with the difference was statistically significant(P<0.05). Logistic regression analysis showed that diabetes, high myopia, preoperative uveitis, preoperative ocular trauma and intraoperative complications were independent influencing factors for high intraocular pressure after cataract surgery in PLG patients. The nomogram model constructed in this study had good fitting effect, and the area under the ROC curve was 0.906(0.890-0.921), indicating that it had strong predictive ability.

CONCLUSION: PLG patients with intraoperative complications, preoperative uveitis, ocular trauma, diabetes and high myopia had higher risk of high intraocular pressure after cataract surgery. Clinical doctors should pay more attention to these patients in order to improve the treatment prognosis.