标题：难治性青光眼患者经巩膜810睫状体光凝术后眼压变化及影响因素

      作者：庞彦利，陈瑞强，汪雪婷    濮阳市第二人民医院(濮阳市眼科医院)三病区青光眼科，河南 濮阳 457000

      卷次： 2024年35卷8期

      【摘要】 目的 探讨难治性青光眼患者经巩膜 810睫状体光凝术后眼压变化及其影响因素。方法 选取2018年7月到2022年12月濮阳市第二人民医院收治的181例难治性青光眼患者作为研究对象。所有患者均接受经巩膜810睫状体光凝术治疗。比较所有患者术前、术后1 d、1周、1个月、3个月、6个月的眼压。根据患者术后6个月的眼压分为眼压控制良好组(眼压6~21 mmHg) 151例和眼压控制不佳组(眼压>21 mmHg或<6 mmHg) 30例。收集两组患者的相关临床资料，采用单因素分析及多因素Logistic回归分析方程分析影响患者术后眼压的因素。结果 患者术后 1 d、1周、1个月、3个月、6个月的眼压分别为(28.79±12.44) mmHg、(21.79±11.30) mmHg、(18.62±7.81) mmHg、(16.38±7.45) mmHg、(13.88±7.41) mmHg，均较术前眼压(47.06±12.29) mmHg降低，差异均有统计学意义(P<0.05)；两组患者术后1 d、1周、1个月、3个月的眼压比较差异均无统计学意义(P>0.05)，但眼压控制良好组患者术后6个月的眼压为(13.16±4.45) mmHg，明显低于眼压控制不佳组的(17.50±14.91) mmHg，差异有统计学意义(P<0.05)；单因素分析结果显示，两组患儿的年龄、性别、术眼、吸烟史、饮酒史、青光眼家族史比较差异均无统计学意义(P>0.05)，但眼压控制良好组患者的高血压史、糖尿病史、高脂血症史占比明显低于眼压控制不良组，差异均有统计学意义(P<0.05)；多因素Logistic回归分析结果显示，高血压史、糖尿病史、高脂血症史均是难治性青光眼患者经巩膜810睫状体光凝术后眼压的影响因素(P<0.05)。结论 经巩膜 810睫状体光凝术治疗可降低难治性青光眼患者眼压，高血压史、糖尿病史、高脂血症史均是影响患者术后眼压的因素。
      【关键词】 难治性青光眼；经巩膜810睫状体光凝术；眼压；影响因素
      【中图分类号】 R775 【文献标识码】 A 【文章编号】 1003—6350（2024）08—1106—05

Changes of intraocular pressure after transscleral 810 cyclophotocoagulation in patients with refractoryglaucoma and its influencing factors.
PANG Yan-li, CHEN Rui-qiang, WANG Xue-ting. Department of Glaucoma, Ward3, the Second People's Hospital of Puyang City, Puyang Eye Hospital, Puyang 457000, Henan, CHINA
【Abstract】 Objective To investigate the changes of intraocular pressure after transscleral 810 cyclophotocoagu-lation in patients with refractory glaucoma and its influencing factors. Methods A total of 181 patients with refractoryglaucoma admitted to the Second People's Hospital of Puyang from July 2018 to December 2022 were selected as thestudy subjects. All patients were treated with transscleral 810 cyclophotocoagulation. The intraocular pressure (IOP) of allpatients was compared before surgery and at 1 day, 1 week, 1 month, 3 months, and 6 months after surgery. According tothe IOP at 6 months after operation, patients were divided into a well-controlled group (IOP 6-21 mmHg) with 151 casesand a poorly-controlled group (IOP >21 mmHg or <6 mmHg) with 30 cases. The relevant clinical data of the two groupswere collected, and the factors affecting the postoperative IOP were analyzed by univariate analysis and multiple Logis-tic regression analysis. Results The intraocular pressure of patients at 1 day, 1 week, 1 month, 3 months, and 6 monthsafter operation were (28.79 ± 12.44) mmHg, (21.79 ± 11.30) mmHg, (18.62 ± 7.81) mmHg, (16.38 ± 7.45) mmHg, and(13.88±7.41) mmHg, respectively, which were significantly lower than the preoperative intraocular pressure of (47.06±12.29) mmHg (P<0.05). There was no significant difference in IOP at 1 day, 1 week, 1 month, and 3 months between thetwo groups (P>0.05), but the IOP of the well-controlled group was (13.16±4.45) mmHg at 6 months after surgery, whichwas significantly lower than (17.50±14.91) mmHg of the poorly-controlled group (P<0.05). Univariate analysis showed thatthere were no statistically significant differences in age, gender, ocular surgery, smoking history, drinking history, and fami-ly history of glaucoma between the two groups (P>0.05), but the proportions of hypertension history, diabetes history, andhyperlipidemia in the well-controlled IOP group were significantly lower than those in the poorly controlled IOP group (P<0.05). Multivariate Logistic regression analysis showed that history of hypertension, diabetes, and hyperlipidemia were allfactors influencing IOP in patients with refractory glaucoma after transscleral 810 photocoagulation. Conclusion Transs-cleral 810 cyclophotocoagulation in the therapy of patients with refractory glaucoma can reduce the intraocular pressure,and the history of hypertension, diabetes, hyperlipidemia were influencing factors of intraocular pressure after surgery.
      【Key words】 Refractory glaucoma; Transscleral 810 cyclophotocoagulation; Intraocular pressure; Influencing factors