摘要
目的探讨原发性闭角型青光眼(primary angle closure glaucoma,PACG)合并白内障患者术后发生干眼症的影响因素。方法回顾性分析2019年6月—2021年6月通辽市科尔沁区第一人民医院收治的168例PACG合并白内障患者的临床资料,所有入选者均进行相同的手术方案。术后3个月对患者进行复查及评估,根据患者术后是否发生干眼症分为发生组(n=40)与未发生组(n=128)。统计两组临床资料,分析PACG联合白内障患者术后发生干眼症的危险因素。结果168例PACG联合白内障患者术后共有40例发生干眼症,发生率为23.81%(40/168);两组切口长度≥2 mm、术前合并糖尿病、术中超声能量释放总和≥15%、术眼术中在显微镜下暴露时间≥20 min的患者占比比较,差异有统计学意义(χ^(2)=21.571、14.413、22.086、23.691,P<0.001);两组性别、年龄、术前合并高血压、手术入路方式、术中麻醉方式比较,差异无统计学意义(P>0.05);多因素Logistic回归分析显示:切口长度≥2 mm、术前合并糖尿病、术中超声能量释放总和≥15%、术眼术中在显微镜下暴露时间≥20 min是PACG联合白内障患者术后发生干眼症的独立危险因素(OR=5.571、4.385、5.742、6.067,P<0.001)。结论PACG合并白内障患者术后干眼症发生率较高,切口长度≥2 mm、术前合并糖尿病、术中超声能量释放总和≥15%、术眼术中在显微镜下暴露时间≥20 min是其独立危险因素,临床需予以高度重视,以改善患者预后。
Objective To investigate the influencing factors of postoperative dry eye in patients with primary angleclosure glaucoma(PACG)complicated with cataract.Methods The clinical data of 168 patients with PACG complicated with cataract admitted to the First People’s Hospital of Horqin District,Tongliao City from June 2019 to June2021 were retrospectively analyzed.All the selected patients underwent the same surgical plan.The patients were reexamined and evaluated 3 months after the operation,and they were divided into the occurrence group(n=40)and the non-incident group(n=128)according to whether the patients had dry eye after the operation.The clinical data of the two groups were collected,and the risk factors of dry eye after PACG combined with cataract surgery were analyzed.Results A total of 40 of 168 patients with PACG combined with cataract developed dry eye after surgery,with an incidence rate of 23.81%(40/168).The proportion of patients with incision length>2 mm,preoperative combined with diabetes,total intraoperative ultrasonic energy release≥15%,intraoperative exposure time under microscope≥20 min in the two groups was compared,and the difference was statistically significant(χ^(2)=21.571,14.413,22.086,23.691,P<0.001).There was no statistically significant difference in gender,age,preoperative hypertension,surgical approach and intraoperative anesthesia between the two groups(P>0.05).Multivariate logistic regression analysis showed that:incision length≥2 mm,preoperative diabetes mellitus,total intraoperative ultrasound energy release≥15%,and intraoperative exposure time under microscope≥20 min were independent risk factors for postoperative dry eye in patients with PACG combined with cataract(OR=5.571,4.385,5.742,6.067,P<0.001).Conclusion The incidence of postoperative dry eye in PACG patients with cataract is higher.The incision length≥2 mm,preoperative diabetes mellitus,intraoperative ultrasound energy release sum≥15%,and intraoperative exposure time under microscope≥20 min are independen
作者
龚茫来
GONG Manglai(Department of Ophthalmology,the First People's Hospital of Horqin District,Tongliao,Inner Mongolia Autonomous Region,028000 China)
出处
《系统医学》
2022年第13期67-70,共4页
Systems Medicine
关键词
原发性闭角型青光眼
白内障
干眼症
影响因素
Primary angle-closure glaucoma
Cataract
Dry eye syndrome
Influencing factors
