| 陆慧慧,张翔翔,何娜,等.白内障伴闭角型青光眼患者术后干眼的危险因素分析[J].中国临床保健杂志,2025,28(6):812-816. |
| 白内障伴闭角型青光眼患者术后干眼的危险因素分析 |
| The risk factors of postoperative dry eye in patients with cataract complicated by angle-closure glaucoma |
| 投稿时间：2025-07-02 |
| DOI：10.3969/J.issn.1672-6790.2025.06.015 |
| 中文关键词: 白内障摘除术 青光眼,闭角型 干眼 保护因素 危险因素 |
| 英文关键词: Cataract extraction Glaucoma,angle-closure Dry eye Protective factors Risk factors 〖FL |
| 基金项目:浙江省医药卫生科技计划项目(2023KY1282)；浙江省金华市科技计划项目(2023-3-123) |
| 作者 | 单位 | E-mail | | 陆慧慧 | 金华市中心医院,眼科,浙江金华 321000 | 32113094@qq.com | | 张翔翔 | 金华市中心医院,眼科,浙江金华 321000 | 32113094@qq.com | | 何娜 | 金华市中心医院,眼科,浙江金华 321000 | 32113094@qq.com | | 包菁 | 金华市中心医院,眼科,浙江金华 321000 | 32113094@qq.com | | 王沁 | 金华市中心医院,内分泌科,浙江金华 321000 | 32113094@qq.com |
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| 中文摘要: |
| 目的 探讨白内障伴闭角型青光眼患者术后干眼的危险因素。方法 回顾性病例对照研究。选取2021年1月至2025年3月金华市中心医院收治的188例白内障伴闭角型青光眼手术患者,术后随访3个月,根据是否发生干眼,将患者分为干眼组与非干眼组。对比2组患者性别、年龄、体重指数、合并糖尿病、病程、眼别、术前眼压、白内障核硬度、闭角型青光眼分型、高眼压持续时间、手术方式、手术切口大小、超声能力释放总和、手术时长、睑脂黏度、结膜松弛分级、睑板腺功能障碍、术后眼压波动、用眼卫生的差异性；采用多因素logistic回归分析影响术后干眼的相关因素。结果 188例患者中,术后干眼发生率为38.83%。;眼组73例,非干眼组115例；2组患者的性别、体重指数、病程、眼别、术前眼压、手术方式比较,差异无统计学意义(P＞0.05)；2组患者的年龄、合并糖尿病、白内障核硬度、闭角型青光眼分型、高眼压持续时间、手术切口大小、超声能力释放总和、手术时长、睑脂黏度、结膜松弛分级、睑板腺功能障碍、术后眼压波动、用眼卫生等比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,年龄大、合并糖尿病、急性闭角型青光眼、高眼压持续时间长、手术切口大、超声能力释放总和大、手术时间长、结膜松弛分级高、睑板腺功能障碍、术后眼压波动大是术后干眼的危险因素(P＜0.05),白内障核硬度Ⅰ~Ⅱ级、睑脂黏度稀薄与适中、用眼卫生良好是其保护因素(P＜0.05)。结论 白内障伴闭角型青光眼患者术后干眼发生率较高,年龄、合并糖尿病、白内障核硬度、闭角型青光眼分型、高眼压持续时间、手术切口大小、超声能力释放总和、手术时长、睑脂黏度、结膜松弛分级、睑板腺功能障碍、术后眼压波动以及用眼卫生等因素均与术后干眼的发生有关联性。 |
| 英文摘要: |
| Objective To explore the incidence and influencing factors of dry eye after surgery in patients with cataract and angle-closure glaucoma,so as to provide guidance for the formulation of clinical prevention and intervention plans.Methods Retrospective case-control study.188 patients with cataract and angle-closure glaucoma who underwent surgery at Jinhua Central Hospital from January 2021 to March 2025 were selected and followed up for 3 months after surgery.According to whether dry eye occurred or not,the patients were divided into the dry eye group and the non-dry eye group.The differences in general data between the two groups,including gender,age,body mass index,comorbid diabetes,disease course,eye affected,intraocular pressure before surgery,cataract nuclear hardness,angle-closure glaucoma type,duration of high intraocular pressure,surgical method,size of surgical incision,total ultrasonic energy release,operation duration,meibomian gland secretion viscosity,conjunctival laxity grade,meibomian gland dysfunction,fluctuation of intraocular pressure after surgery,and eye hygiene,were compared.Multivariate Logistic regression analysis was used to explore the related factors influencing dry eye after surgery.Results Among the 188 patients,73 cases of dry eye occurred after surgery,with an incidence of 38.83%.There were 73 cases in the dry eye group and 115 cases in the non-dry eye group.There were no significant differences in gender,body mass index,disease course,eye affected,intraocular pressure before surgery,and surgical method between the two groups (P>0.05).However,there were significant differences in age,comorbid diabetes,cataract nuclear hardness,angle-closure glaucoma type,duration of high intraocular pressure,size of surgical incision,total ultrasonic energy release,operation duration,meibomian gland secretion viscosity,conjunctival laxity grade,meibomian gland dysfunction,fluctuation of intraocular pressure after surgery,and eye hygiene between the two groups (P<0.05).Logistic analysis showed that old age,comorbid diabetes,acute angle-closure glaucoma,long duration of high intraocular pressure,large size of surgical incision,high total ultrasonic energy release,long operation duration,high conjunctival laxity grade,meibomian gland dysfunction,and large fluctuation of intraocular pressure after surgery were risk factors for dry eye after surgery (P<0.05),while cataract nuclear hardness Ⅰ-Ⅱ,thin or moderate meibomian gland secretion viscosity and good eye hygiene were protective factors (P<0.05).Conclusions Patients with cataract accompanied by angle-closure glaucoma have a higher incidence of postoperative dry eye.Factors such as age,comorbid diabetes,cataract nucleus hardness,angle-closure glaucoma subtype,duration of high intraocular pressure,surgical incision size,total ultrasonic energy released,surgical duration,meibum viscosity,conjunctival relaxation grading,meibomian gland dysfunction,postoperative intraocular pressure fluctuation,and ocular hygiene are all associated with the occurrence of postoperative dry eye. |
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