目的：探讨原发性闭角型青光眼术后恶性青光眼发生的危险因素，为恶性青光眼的防治提供理论依据。

方法：回顾性分析2012-06/2016-06于我院眼科治疗的原发性闭角型青光眼患者767例965眼的临床资料，调查术后是否出现恶性青光眼，将术后1a出现恶性青光眼的患眼设为观察组，随机选取未出现恶性青光眼患者50眼设为对照组。调查两组患者性别、年龄、术前高眼压情况、房角结构、眼轴长度、晶状体厚度、前房深度、是否合并糖尿病、高血压等，单因素分析其危险因素，通过多因素Logistic回归分析探讨其独立危险因素。

结果：选取的965眼原发性闭角型青光眼患者中术后1a出现恶性青光眼30眼，恶性青光眼发生率为3.1%； 单因素分析结果显示：年龄、术前持续高眼压、眼轴长度、前房深度、晶状体厚度、房角完全关闭是原发性闭角型青光眼术后出现恶性青光眼的危险因素，组间比较差异具有统计学意义(P<0.05)； 多因素Logistic回归分析结果显示年龄(OR=2.521，95%CI为1.434～8.876)、术前持续高眼压(OR=2.483，95%CI为2.123～11.543)、眼轴长度(OR=2.654，95%CI为1.547～12.678)、房角完全关闭(OR=3.212，95%CI为1.543～8.675)是原发性闭角型青光眼术后恶性青光眼的独立危险因素。

结论：我院原发性闭角型青光眼术后恶性青光眼发生率为3.1%，年龄、术前持续高眼压、眼轴长度、房角完全关闭均可增加恶性青光眼的发生风险，对于有该类危险因素的患者术中需特别注意。

METHODS: The clinical data of 767 cases(965 eyes)of primary angle-closure glaucoma patients treated in our hospital from June 2012 to June 2016 were retrospectively analyzed. Patients were divided into two groups according to the postoperative investigation, patients with malignant glaucoma were divided into observation group, and 50 eyes without malignant glaucoma were randomly selected into control group. The gender, age, preoperative high intraocular pressure, chamber angle structure, axial length, crystal thickness, anterior chamber depth, diabetes mellitus, and hypertension of the patients in two groups were investigated. The risk factors were analyzed by single factor analysis, and the independent risk factors were analyzed by multivariate logistic regression analysis.

RESULTS: Malignant glaucoma occurred in 30 eyes after the surgery of primary angle closure glaucoma in 965 eyes with an incidence rate of 3.1%. The single factor analysis showed that age, preoperative high intraocular pressure, axial length, anterior chamber depth, lense thickness, complete closure of atrial angle were the risk factors of malignant glaucoma after primary angle closure glaucoma surgery, comparison between groups showed statistical significance(P<0.05). Multivariate logistic regression analysis showed that age(OR=2.521, 95%CI=1.434-8.876), preoperative continuous high intraocular pressure(OR=2.483, 95%CI =2.123-11.543), axial length(OR=2.654, 95%CI=1.547-12.678), complete closure of atrial angle(OR=3.212, 95%CI=1.543-8.675)were the independent risk factors for malignant glaucoma after primary angle closure glaucoma surgery.

CONCLUSION: The incidence rate of malignant glaucoma after primary angle-closure glaucoma surgery in our hospital is 3.1%. Age, preoperative high intraocular pressure, axialc length, complete closure of atrial angle can rise the risk of occurring malignant glaucoma, so special attention shall be payed for this kind of patients.