目的：探讨原发性闭角型青光眼(PACG)合并白内障患者术后持续高眼压的影响因素。

方法：回顾性分析2022年2月至2025年5月期间于本院眼科接受标准白内障超声乳化联合人工晶状体植入术(Phaco+IOL)或同时联合房角分离术治疗的PACG合并白内障患者的临床资料。根据术后3 mo用药后眼压是否持续高于21 mmHg，将患者分为高眼压组和正常眼压组。比较两组患者的人口学特征、术前、术中以及术后资料，采用Logistic回归分析术后高眼压的影响因素。

结果：纳入PACG合并白内障患者106例106眼，正常眼压组85例，男35例，女50例，平均年龄58.42±6.37岁； 高眼压组21例，男10例，女11例，平均年龄60.53±6.94岁； 临床资料分析显示，两组患者年龄、性别、体质量指数(BMI)、合并高血压、术前眼压及是否<21 mmHg、前房深度、角膜直径、晶状体核硬度、手术方式、手术时间、术后新生血管、缝合处理、用药情况比较无差异(均P>0.05)； 两组患者糖尿病、高度近视、术中并发症、术后炎症反应比较有差异(均P<0.05)。Logistic回归分析显示，合并糖尿病(OR=1.997，95%CI：1.174-3.397，P=0.011)、合并高度近视(OR=1.590，95%CI：1.049-2.409，P=0.029)、有术中并发症(OR=3.416，95%CI：1.641-7.110，P=0.001)、中度/重度术后炎症反应(OR=2.813，95%CI：1.209-6.547，P=0.016)是PACG合并白内障患者术后发生持续高眼压的影响因素。

结论：PACG合并白内障术后发生持续高眼压受多种因素影响，其中合并糖尿病、合并高度近视、有术中并发症、中度/重度术后炎症反应是其影响因素。

METHODS: A retrospective analysis was conducted on the clinical data of patients with PACG and cataract who underwent standard phacoemulsification combined with intraocular lens implantation(Phaco+IOL)or phacoemulsification combined with goniosynechialysis in the Ophthalmology Department of the hospital from February 2022 to May 2025. According to whether the IOP was persistently higher than 21 mmHg after 3 mo of medication postoperatively, the patients were divided into the high IOP group and the normal IOP group. The demographic characteristics, preoperative, intraoperative and postoperative data of the two groups were compared, and Logistic regression analysis was used to analyze the influencing factors of postoperative high IOP.

RESULTS: A total of 106 patients(106 eyes)with PACG and cataract were included. The normal IOP group consisted of 85 patients(35 males and 50 females), with an average age of 58.42±6.37 y, and the high IOP group consisted of 21 patients(10 males and 11 females), with an average age of 60.53±6.94 y. Clinical data analysis showed that there were no statistically significant differences between the two groups in terms of age, gender, body mass index(BMI), comorbidity with hypertension, preoperative IOP(whether <21 mmHg), anterior chamber depth, corneal diameter, lens nucleus hardness, surgical method, surgical time, postoperative neovascularization, suturing method, and medication use(all P>0.05). However, there were statistically significant differences between the two groups in terms of diabetes, high myopia, intraoperative complications, and postoperative inflammatory responses(all P<0.05). Logistic regression analysis showed that combined diabetes(OR=1.997, 95% CI: 1.174-3.397, P=0.011), high myopia(OR=1.590, 95% CI: 1.049-2.409, P=0.029), intraoperative complications(OR=3.416, 95% CI: 1.641-7.110, P=0.001), and moderate/severe postoperative inflammatory response(OR=2.813, 95% CI: 1.209-6.547, P=0.016)were the influencing factors for persistent high IOP in patients with PACG and cataract after surgery.

CONCLUSION: The occurrence of persistent high IOP after PACG and cataract surgery is influenced by multiple factors, including the presence of diabetes, high myopia, intraoperative complications, and moderate/severe postoperative inflammatory response.