Abstract:AIM: To analyze the influencing factors of dry eye after ciliary photocoagulation in patients with refractory glaucoma, and to build a risk prediction model.
METHODS:From January 2021 to January 2024, the clinical data of 303 patients(308 eyes)with refractory glaucoma in our hospital were analyzed retrospectively, and the incidence of dry eye was counted 3 mo after operation. They were divided into two groups according to the incidence of dry eye after operation: an occurrence group(n=105)and a non-occurrence group(n=198). The medical records of the two groups were collected, and the influencing factors of dry eye were analyzed by Logistic regression. The Nomogram model was made by R3.4.3 software based on the results of Logistic regression analysis. The risk prediction ability of Nomogram model was evaluated by receiver operating characteristic(ROC)curve, and the calibration degree of Nomogram model was detected by calibration curve.
RESULTS:The incidence of dry eye in refractory glaucoma patients after ciliary photocoagulation was 34.65%. Age(OR=1.343, 95% CI: 1.102-1.637), diabetes(OR=1.219, 95% CI: 1.044-1.423), Sjogren's syndrome(OR=1.289, 95% CI: 1.070-1.553), keratoconjunctival diseases(OR=1.366, 95% CI: 1.116-1.672), eyelid fat viscosity 3-4 grade(OR=1.168, 95% CI: 1.040-1.311), conjunctival relaxation 3-4 grade(OR=1.158, 95% CI: 1.028-1.305), exposure time under glasses during operation(OR=1.415, 95% CI: 1.129-1.773), the average daily use time of electronic products after operation(OR=1.366, 95% CI: 1.108-1.685)and the auxiliary use of hormone eye drops after operation(OR=1.231, 95% CI: 1.026-1.477)were the influencing factors of dry eye after ciliary body photocoagulation in refractory glaucoma patients(all P<0.05). ROC curve showed that the area under the curve, sensitivity and specificity of Nomogram model in predicting postoperative dry eye syndrome were 0.930(95% CI: 0.895-0.956), 96.19% and 82.83%, respectively. The internal verification of Nomogram model showed that the C-index value was 0.859, Hosmer-Lemeshow goodness-of-fit test(χ2=1.972, P=0.396)showed a good fit.
CONCLUSION: Age, diabetes, Sjogren's syndrome, keratoconjunctival disease, eyelid fat viscosity 3-4 grade, conjunctival relaxation 3-4 grade, exposure time under glasses during operation, average daily use time of electronic products after operation, and adjuvant use of hormone eye drops after operation are the influencing factors of dry eye in refractory glaucoma patients after ciliary body photocoagulation, the risk prediction model based on the above factors can predict the risk of dry eye after operation.
