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[摘要]
目的:影响白内障超声乳化人工晶状体植入联合前段玻璃体切除术治疗恶性青光眼疗效的相关因素分析。
方法:选取我院眼科2011-06/2016-06收治的恶性青光眼行白内障超声乳化人工晶状体植入联合前段玻璃体切除手术治疗的患者23例25眼,分析其手术前后眼压、相关眼球解剖学参数变化及其相关性。
结果:术后前房形成可且眼压控制在正常范围者(有效组)共15例16眼,平均年龄51±6.7岁,术后前房形成欠佳者(无效组)共8例9眼,平均年龄45±7.8岁。手术有效率为64%。其中有效组术后中央前房深度由术前0.76±0.53mm加深至2.13±0.82mm,术后眼压(15.4±4.5mmHg)较术前(26.4±8.7mmHg)明显下降。有效组患者术前巩膜突间距(11.25±0.39mm)及眼轴长度(22.16±1.16mm)均大于无效组(10.86±0.49mm、20.98±0.62mm),差异有统计学意义(P<0.05)。有效组和无效组患者年龄及眼轴长度单因素分析结果均有统计学意义(P<0.05)。通过 Logistic回归分析发现年龄和眼轴长度是术后治疗效果欠佳的独立危险因素,差异均有统计学意义(P<0.05)。
结论:年龄和眼轴长度是术后治疗效果欠佳的独立危险因素。
[Key word]
[Abstract]
AIM: To investigate the influence factors of phacoemulsification combined with anterior vitrectomy for treating malignant glaucoma.
METHODS: Totally 23 cases(25 eyes)of malignant glaucoma patients, who were in-patient in ophthalmology of Wuhan Tongji Hospital from June 2011 to June 2016, underwent phacoemulsification combined with anterior vitrectomy, were involved in this study. The intraocular pressure and related ocular anatomy parameter change and its correlation were analyzed pre-and post-operatively.
RESULTS: There were 15 cases(16 eyes), average 51±6.7 years old, had deepened anterior chamber and intraocular pressure within the normal range(reffered as effective)post-operatively, in the other 8 cases(9 eyes), average 45±7.8 years old, postoperative anterior chamber formation were poor(referred as ineffective). Surgery effective rate was 64%. As for the effective group, the postoperative anterior chamber depth(2.13±0.82mm), significantly deepened compared with preoperative(0.76±0.53mm), and postoperative intraocular pressure(15.4±4.5mmHg)significantly declined compared with preoperative(26.4±8.7mmHg). The effective group had larger preoperative scleral spur distance and ocular axial length than ineffective group, 11.25±0.39mm vs 10.86±0.49mm and 22.16±1.16mm vs 20.98±0.62mm respectively, and the difference was statistically significant(P<0.05). Age and the ocular axial length were statistically significant between effective and ineffective group by using single factor analysis results(P<0.05). By logistic regression analysis, age and ocular axial length were independent risk factors for poor postoperative treatment effect(P<0.05).
CONCLUSION: The younger age and the ocular axial length is risk factors for poor postoperative treatment effect of malignant glaucoma by phacoemulsification combined with anterior vitrectomy.
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