Abstract:AIM: To investigate the influencing factors of persistent high intraocular pressure(IOP)after surgery in patients with primary angle-closure glaucoma(PACG)and cataract.
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.
