Risk factors for flat anterior chamber after glaucoma filtration surgery

查看全文 作　　者：Xiang-Ji [1,2]Zi;Richard [3,4]Filek;Xiang-Ge [5]He;Wei [5]Wang;Hong [4]Liu;Lian [1]He;Yu-Rong [6]Tang;Lin [1]Xie

机构地区：[1]Department of Ophthalmology, the Third Affiliated Hospital,Chongqing Medical University, Chongqing 400016, China;[2]Department of Ophthalmology, Institute of Surgery Research,Daping Hospital, Third Military Medical University,Chongqing 400042, China;[3]Department of Pathology and Laboratory Medicine, Western University, London ON N6A 3K7, Canada;[4]Ivey Eye Institute, St. Joseph's Hospital, London ON N6A4V2, Canada;[5]Chongqing Aier Eye Hospital of Aier Eye Hospital Group,Chongqing 400020, China;[6]Department of Ophthalmology, People's Hospital Zhongshan Branch, Chongqing 400013, China

出　　处：《International Journal of Ophthalmology(English edition)》索引2018年第11卷第8期,共8页

摘　　要：AIM: To investigate the incidence rate and risk factors for grade Ⅲ flat anterior chamber(FAC) after glaucoma filtration surgery based on 5-year data.METHODS: Patients who underwent glaucoma filtration surgery in Daping hospital from January 2009 to December 2013 were enrolled in this retrospective study. The incidence of grade Ⅲ FAC following glaucoma filtration surgery was determined. Regression analysis was performed to investigate the influence of glaucoma type, surgical approach, age, and preoperative intraocular pressure(IOP) on the risk of postoperative FAC.RESULTS: A total of 2179 eyes receiving anti-glaucoma surgery were included. Ninety-one eyes suffered from postoperative FAC, with an overall incidence rate of 4.18%. Of 471 eyes with primary open angle glaucoma(POAG), grade Ⅲ FAC occurred in only 3 eyes(0.64%). Primary angleclosure glaucoma(PACG) was diagnosed in 1076 eyes, 39(3.62%) of which developed grade Ⅲ FAC, including 12 eyes(12/300, 4%) with acute PACG(aP ACG) and 27 eyes(27/776, 3.48%) with chronic PACG(c PACG). Six of 259 eyes(2.32%) with secondary glaucoma, 28 of 186 eyes(15.05%) with neovasular glaucoma, 1 of 66 eyes(1.52%) with congenital glaucoma, and 14 of 115 eyes(12.17%) with remnant glaucoma suffered from grade Ⅲ FAC. Of 6 eyes with mixed glaucoma, none developed grade Ⅲ FAC after surgery. When stratified by surgical approach, 24 of 766 eyes(3.13%) undergoing trabeculectomy, 21 of 924 eyes(2.27%) treated by trabeculectomy plus mitomycin C(MMC), 18 of 109 eyes(16.51%) undergoing Ahmed glaucoma valve implantation, 23 of 201 eyes(11.44%) managed by Ahmed implantation plus MMC, and 5 of 133 eyes(3.76%) treated by Ahmed implantation plus lens extraction or vitrectomy developed grade Ⅲ FAC. Logistic regression analysis revealed that factors including neovasular glaucoma, remnant glaucoma, glaucoma valve implantation, glaucoma valve implantation+MMC, glaucoma valve implantation+vitrectomy, age>60 y, and IOP at admission >50 mm Hg were significantly associated with an increased risk for grade Ⅲ FAC.CONCLUSION: The overall incidence of grade Ⅲ FAC after glaucoma filtration surgery is 4.18%. Patients with neovasular glaucoma and remnant glaucoma are at a higher risk of developing FAC. Ahmed glaucoma valve implantation is associated with a higher risk for grade Ⅲ FAC compared with trabeculectomy. No significant correlation was observed between the use of MMC in glaucoma filtration surgery and the risk of postoperative FAC. Higher IOP at admission(>50 mm Hg) and old age(>60 y) are risk factors for grade Ⅲ FAC. 关键词：GLAUCOMA filtration surgery grade Ⅲ flat anterior chamber TRABECULECTOMY glaucoma valve implantation mitomycin C

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Risk factors for flat anterior chamber after glaucoma filtration surgery

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