Keenan Tiarnan D L, Salmon John F, Yeates David, Goldacre Michael
Ophthalmology Department, Oxford Eye Hospital, Oxford University, UK.
J Glaucoma. 2009 Mar;18(3):201-5. doi: 10.1097/IJG.0b013e318181540a.
Eyes that are predisposed to primary angle closure usually have a shallow anterior chamber secondary to a relatively forward position of the lens and progressive lens thickening with ageing. The aim of this study was to examine trends over time in rates of primary angle closure glaucoma (PACG) in England, and to compare these rates with rates of cataract surgery.
Hospital episode statistics and the hospital inpatient inquiry were analyzed for PACG as the main diagnosis between the years 1968 and 2004, and for cataract surgery over the same period. Age-specific and sex-specific rates of PACG and cataract surgery were calculated over 3 representative time periods.
Annual rates of patients with PACG did not change significantly from the late 1960s to the mid-1980s and then increased until the early 1990s before reaching a plateau; from 1999 to 2004, rates of patients with PACG declined significantly. From the 1980s to 2004, annual rates of patients undergoing cataract surgery increased significantly and substantially. In the recent period of decline in PACG, the decline was greatest in older age groups, whereas rates of cataract surgery increased significantly in all age groups for both men and women throughout the whole time period.
Rates of patients with PACG have started to decline in recent years, after a long period of increases in rates of patients undergoing cataract surgery. Although other explanations are possible, this lends support to the hypothesis that cataract surgery may reduce the likelihood of acute angle closure.
易患原发性闭角型青光眼的眼睛通常前房较浅，这是由于晶状体相对靠前的位置以及随着年龄增长晶状体逐渐增厚所致。本研究的目的是调查英格兰原发性闭角型青光眼（PACG）发病率随时间的变化趋势，并将这些发病率与白内障手术率进行比较。
分析1968年至2004年间以PACG为主要诊断的医院事件统计数据和医院住院患者查询数据，以及同期的白内障手术数据。计算三个具有代表性时间段内特定年龄和性别的PACG及白内障手术发病率。
从20世纪60年代末到80年代中期，PACG患者的年发病率没有显著变化，然后持续上升直到90年代初达到平稳状态；1999年至2004年，PACG患者的发病率显著下降。从20世纪80年代到2004年，接受白内障手术患者的年发病率显著且大幅上升。在PACG近期下降期间，老年组下降幅度最大，而在整个时间段内，所有年龄组的男性和女性白内障手术率均显著上升。
在接受白内障手术患者的发病率长期上升之后，近年来PACG患者的发病率已开始下降。尽管可能有其他解释，但这支持了白内障手术可能降低急性闭角可能性的假设。
