[Treatment approaches for affected eyes in hospitalized patients with acute primary angle-closure glaucoma: a multicenter retrospective analysis]
- PMID: 40921656
- DOI: 10.3760/cma.j.cn112142-20241031-00490
[Treatment approaches for affected eyes in hospitalized patients with acute primary angle-closure glaucoma: a multicenter retrospective analysis]
Abstract
Objective: To investigate the treatment approaches for attacking eyes in patients with clinical acute primary angle-closure glaucoma (APACG) and their alignment with the recommendations in the Chinese Glaucoma Guidelines (2020). Methods: A cross-sectional study was conducted, including medical records of consecutive inpatients diagnosed with APACG from 22 ophthalmic centers nationwide during three periods: September 7, 2020, to January 6, 2021; September 7, 2021, to January 6, 2022; and September 7, 2022, to January 6, 2023. For patients meeting the inclusion criteria in both eyes, the right eye was uniformly selected for analysis. Demographic characteristics, medical history, and ocular examination data were collected. Patients were categorized into medication group, laser treatment group, and surgical treatment group based on their final treatment after admission. The proportion of different treatment approaches and their consistency with the Chinese Glaucoma Guidelines (2020) were analyzed. Statistical analysis was performed using the chi-square test. Results: A total of 2 567 patients (2 567 eyes) with APACG were included, with a mean age of (66.7±9.3) years. Among them, 615 (24.0%) were male and 1 952 (76.0%) were female; 1 431 eyes (55.7%) were right eyes and 1 136 eyes (44.3%) were left eyes. There were 83 eyes (3.2%) in the medication group, 256 eyes (10.0%) in the laser treatment group, and 2 228 eyes (86.8%) in the surgical treatment group. In the surgical treatment group, 1 951 eyes (87.6%) underwent cataract extraction, and 1, 300 eyes (58.3%) received phacoemulsification combined with goniosynechialysis as the preferred surgical approach. The rate of complete consistency between the treatment regimens and the recommendations in the Chinese Glaucoma Guidelines (2020) was 52.4% (1 344/2 567), and the rate of partial consistency was 40.3% (1 035/2 567). Conclusions: Phacoemulsification combined with goniosynechialysis has become the mainstream surgical approach for treating attacking eyes in APACG patients in China. Over 90% of APACG patients received treatment consistent with the Chinese Glaucoma Guidelines (2020).
目的： 探讨临床急性原发性闭角型青光眼（APACG）患者发作眼的治疗方式，及其与《中国青光眼指南（2020年）》推荐意见的匹配程度。 方法： 横断面研究。纳入2020年9月7日至2021年1月6日（2020年研究期间）、2021年9月7日至2022年1月6日（2021年研究期间）和2022年9月7日至2023年1月6日（2022年研究期间）全国22个眼科中心连续诊断为APACG住院患者的病历资料。若双眼均符合纳入标准，统一取右眼进行分析。收集患者的人口学特征、病史和眼部检查信息，根据患者入院后的最终治疗方式分为药物治疗组、激光治疗组和手术治疗组。分析不同治疗方式的占比及其与《中国青光眼指南（2020年）》推荐意见的一致情况。采用χ2检验进行统计学分析。 结果： 共纳入2 567例（2 567只眼）APACG患者，年龄为（66.7±9.3）岁；其中男性615例（24.0%），女性1 952例（76.0%）；1 431只（55.7%）右眼，1 136只（44.3%）左眼；药物治疗组83只眼（3.2%），激光治疗组256只眼（10.0%），手术治疗组2 228只眼（86.8%）。手术治疗组中，1 951只眼（87.6%）接受白内障摘除手术，1 300只眼（58.3%）首选治疗术式为超声乳化白内障吸除联合房角分离术。治疗方案与《中国青光眼指南（2020年）》推荐意见完全一致率为52.4%（1 344/2 567），部分一致率为40.3%（1 035/2 567）。 结论： 超声乳化白内障吸除联合房角分离术已成为中国当前APACG发作眼治疗的主流术式。超90%的APACG患者的治疗方式符合《中国青光眼指南（2020年）》的推荐意见。.