The Eye Institute, The University of Hong Kong, Hong Kong, People's Republic of China.
Indian J Ophthalmol. 2011 Nov-Dec;59(6):471-4. doi: 10.4103/0301-4738.86316.
To determine the risk factors for developing phacomorphic glaucoma in eyes with mature cataracts.
This is a case-control study comprising of 90 eyes with phacomorphic glaucoma and 90 age- and sex-matched control eyes with mature cataracts without phacomorphic glaucoma. Patients with pre-existing glaucoma, previous intraocular surgery and /or absence of documented axial lengths were excluded from this study. Binary logistic regression analysis of the variables, axial length and anterior chamber depth, was performed. Anterior chamber depth of the contralateral eye was used as a proxy measure of the pre-phacomorphic state in the eye with phacomorphic glaucoma as majority of them first presented to our center during the phacomorphic attack without prior measurements of the pre-phacomorphic ACD or lens thickness; therefore, their anterior chamber depth would not be representative of their pre-phacomorphic state. Axial length of 23.7 mm was selected as a cut-off for dichotomized logistic regression based on the local population mean from published demographic data.
The mean age was 73.1 ± 10.2 years. All phacomorphic and control eyes were ethnic Chinese. The mean presenting intraocular pressures were 49.5 ± 11.8 mmHg and 16.7 ± 1.7 mmHg in the phacomorphic and control eyes respectively (P< 0.0001), whilst the median Snellen best corrected visual acuity were light perception and hand movement in the phacomorphic and control eyes respectively. Eyes with phacomorphic glaucoma had shorter axial length of 23.1 ± 0.9 mm median when compared with that of control eyes, 23.7 ± 1.5 mm (P = 0.0006). Eyes with AL ≤ 23.7 mm were 4.3 times as likely to develop phacomorphic glaucoma when compared with AL > 23.7 mm (P = 0.003).
Axial length less than ≤ 23.7 mm was a risk factor for developing phacomorphic glaucoma. Eyes with AL shorter than the population mean were 4.3 times as likely to develop phacomorphic glaucoma compared with eyes with longer than average AL. In an area where phacomorphic glaucoma is prevalent and medical resources are limited, patients with AL shorter than their population mean may be considered for earlier elective cataract extraction as a preventive measure.
确定成熟白内障眼中发生并发性白内障青光眼的危险因素。
本研究为病例对照研究，共纳入 90 例并发性白内障青光眼眼和 90 例年龄和性别匹配的成熟白内障但无并发性白内障青光眼对照眼。排除了有既往青光眼、眼内手术史和/或无明确眼轴长度记录的患者。对变量（眼轴长度和前房深度）进行二元逻辑回归分析。对青光眼眼前房深度采用对侧眼作为参考指标，因为大多数患者在青光眼发作期间首次就诊于我院，且就诊前并未测量前房深度或晶状体厚度；因此，其前房深度不能代表其青光眼前期状态。根据当地发表的人口统计学数据的人群平均值，选择 23.7mm 作为二分类逻辑回归的截断值。
平均年龄为 73.1±10.2 岁。所有并发性白内障和对照眼均为华裔。青光眼组和对照组的平均眼内压分别为 49.5±11.8mmHg 和 16.7±1.7mmHg（P<0.0001），而青光眼组和对照组的最佳矫正视力中值分别为光感和手动。与对照组相比，青光眼组的眼轴长度更短，中位数为 23.1±0.9mm（P=0.0006）。与眼轴长度>23.7mm 的患者相比，眼轴长度≤23.7mm 的患者发生并发性白内障青光眼的风险高 4.3 倍（P=0.003）。
眼轴长度小于或等于 23.7mm 是发生并发性白内障青光眼的危险因素。与眼轴长度长于平均值的患者相比，眼轴长度短于平均值的患者发生并发性白内障青光眼的风险高 4.3 倍。在一个并发性白内障青光眼高发且医疗资源有限的地区，眼轴长度短于平均值的患者可能需要考虑早期进行选择性白内障摘除术作为预防措施。
