Guoji Yanke Zazhi (Jan 2018)
Analysis on risk factors of malignant glaucoma after the surgery for primary angle-closure glaucoma
Abstract
AIM: To investigate the risk factors for malignant glaucoma occurrence after the surgery for primary angle-closure glaucoma, and to provide theoretical basis for the prevention and treatment of malignant glaucoma. 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(POR=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.
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