Department of Cataract Services, Aravind Eye Hospital and PG Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Paediatric Ophthalmology and Strabismus, Aravind Eye Hospital and PG Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India.
Indian J Ophthalmol. 2022 Apr;70(4):1216-1221. doi: 10.4103/ijo.IJO_2371_21.
To evaluate the outcomes and identify favorable prognostic factors in patients of phacomorphic (PMG) and phacolytic glaucoma (PLG) managed by manual small-incision cataract surgery (MSICS).
The medical records of patients with PMG/PLG who had undergone MSICS in a tertiary eye hospital between September 2014 and August 2018 were retrospectively reviewed. Regression analyses were conducted to identify the predictors associated with intraoperative or postoperative complications and a favorable final outcome at 1 month, namely, a best-corrected visual acuity (BCV) of 6/18 or better and an intraocular pressure (IOP) of <21 mm Hg. P < 0.05 was considered statistically significant.
The records of 209 patients with PMG and 279 patients with PLG were eligible for the review. The mean preoperative IOP for PMG and PLG were 43.15 ± 12.9 and 40.05 ± 12.0 mm Hg, respectively (P = 0.006). A younger age (<60 years) was associated with a lower risk of severe postoperative inflammation in both PMG and PLG [OR = 0.45 (0.21-0.99); P = 0.047 and OR = 0.44 (0.23-0.83); P = 0.011, respectively]. There was no significant difference in the final mean logMAR BCV (P = 0.21) and IOP (P = 0.36) in the two groups. The likelihood of a final IOP of <21 mm Hg was significant for symptoms less than a week [OR = 3.52 (1.2-10.2); P = 0.02] in PMG and for absence of vitreous disturbance [OR = 35.0 (3.8-325.7); P = 0.002] in PLG. A BCV of 6/18 or better was strongly associated with symptoms for less than a week [OR = 1.58 (1.0-2.4); P = 0.043] and absence of vitreous disturbance [OR = 23.53 (5.1-108.0); P < 0.001].
Early diagnosis and management can translate to good outcomes in PMG and PLG.
评估在接受手动小切口白内障手术（MSICS）治疗的后发性白内障（PMG）和晶状体溶解性青光眼（PLG）患者中的结局，并确定有利的预后因素。
回顾性分析 2014 年 9 月至 2018 年 8 月期间在一家三级眼科医院接受 MSICS 治疗的 PMG/PLG 患者的病历。进行回归分析以确定与术中或术后并发症以及术后 1 个月时的良好结局（即最佳矫正视力（BCV）为 6/18 或更好，眼压（IOP）<21mmHg）相关的预测因素。P<0.05 被认为具有统计学意义。
共有 209 例 PMG 患者和 279 例 PLG 患者的病历符合纳入标准。PMG 和 PLG 的术前平均 IOP 分别为 43.15±12.9mmHg 和 40.05±12.0mmHg（P=0.006）。在 PMG 和 PLG 中，年龄较轻（<60 岁）与术后重度炎症的风险较低相关[比值比（OR）=0.45（0.21-0.99）；P=0.047 和 OR=0.44（0.23-0.83）；P=0.011]。两组的最终平均 logMAR BCV（P=0.21）和 IOP（P=0.36）无显著差异。PMG 中症状持续时间<1 周（OR=3.52（1.2-10.2）；P=0.02）和 PLG 中无玻璃体混浊（OR=35.0（3.8-325.7）；P=0.002）与最终 IOP<21mmHg 的可能性显著相关。BCV 为 6/18 或更好与症状持续时间<1 周（OR=1.58（1.0-2.4）；P=0.043）和无玻璃体混浊（OR=23.53（5.1-108.0）；P<0.001）密切相关。
早期诊断和治疗可使 PMG 和 PLG 获得良好的结局。
