Case Series Analysis Of 5 Years Hospitalized Patients With Glaucoma At Tianjin Eye Hospital

Objective: To analyze 4539 cases of hospitalized patients with glaucoma sugery at Tianjin Eye Hospital from 2013 to 2017,to provides reference data for the prevention and treatment of glaucoma.Methods: The electronic medical record of inpatients with glaucoma sugery at Tianjin Eye Hospital from 2013 to 2017 were collected,including age,gender,past history,family history,visual acuity,intraocular pressure,duration of inpatient time,diagnosis,surgical type.Results: Primary angle closure glaucoma(PACG)was the most common type,for the ratio was 60.1%,followed by secondary glaucoma(SG)(25.5%),primary open angle glaucoma(POAG)(7.6%),postoperative complications of glaucoma(4.7%),mixed glaucoma(MG)(1.1%),and congenital glaucoma(CG)(0.9%)were decreased in descending order.The most common clinical stage of acute primary angle closure glaucoma(APACG)was symptomatic stage,accounting for 59.9%.In SG,traumatic glaucoma accounted for the most,accounting for26.4%,followed by neovascular glaucoma,accounting for 24.2%,lens-derived glaucoma accounted for 19.9%.The median age of all cases was 63.0 years old,the median age of of PACG was 66.0 years old,followed by MG was 62.5 years old,POAG and glaucoma complications were 62.0 years old,SG was 56.0 years old and CG was 3.0 years old.Females over 50 years old in the PACG group and postoperative complications of glaucoma group was 66.8% and 53.7%,respectively.In the POCG group,the ratio of males over 50 years old was 53.0%.The male-female ratio of PACG,POAG,CG,SG,MG,and postoperative complications of glaucoma was 1:2.26,1:0.51,1:0.86,1:0.55,1:1,and 1:1.52,respectively.Compared with other glaucoma subtypes,more patients with PACG were female(OR=3.454,P < 0.001)and had history of hypertension(OR=1.503,P<0.001),and glaucoma family history(OR=3.365,P<0.001);more patients with POCG or SG were male(OR=2.817,3.199;P<0.001)and had history of diabetes mellitus(OR=1.384,2.050,P<0.001).After operation,intraocular pressure(IOP)decreased in CG,MG,postoperative complications of glaucoma.,POAG,SG,and PACG groups(Z=-5.6,-6.1,-12.0,-14.2,-27.9,-41.8;P<0.001);visual acuity was improved significantly in group POAG,SG and PACG(Z=-6.7,-10.8,-20.1;P<0.001),while visual acuity did not improved significantly in MG,postoperative complications of glaucoma,CG groups(Z=-0,8,-1.3,-1.4;P>0.05).From 2013 to 2017,the rate of phacotrabeculectomy(Phaco-Trab)in PACG showed an upward trend,from 31.4% to52.4%,and the rate of trabeculectomy(Trab)reduced from 41.6% to 17.2%.After laser peripheral iridectomy(LPI),transscleral diode laser cyclophotocoagulation(TSCP),phacoemulsification,(Phaco),Trab,Phaco-Trab,IOP of PACG decreased(Z=-7,4,-9.4,-14.5,-23.7,-27.8;P<0.001),visual acuity of PACG improved(Z=-5.7,-2.1,-11.5,-11.5,-10.3;P<0.05).After glaucoma drainage implant(GDI)、TSCP、Trab、Phaco-Trab,IOP of POAG decreased(Z=-2.9,-3.5,-8.6,-10.2;P≤0.003),after Phaco-Trab visual acuity of POAG improved(Z=-6.7,P<0.001).Conclusion: Of the 4539 hospitalized cases of glaucoma,PACG was the most common type,followed by SG and POAG.The symptomatic phase was still the most common clinical stage of APACG.In SG,traumatic glaucoma was the most common type,followed by neovascular glaucoma and lens-derived glaucoma.Compared with other types of glaucoma,more patients with PACG are female and had hypertension history and Glaucoma family,more patients with SG or POAG are male and had history of diabetes mellitus.After surgical treatment,the IOP of CG,MG,postoperative complications of glaucoma.,POAG,SG,and PACG groups decrease,the difference was statistically significant;the visal acuity of POAG,SG,and PACG improved and the difference was statistically significant.During the 2013-2017,the rate of Phaco-Trab surgery in PACG showed an upward trend,and the rate of Trab was on the decline.After LPI,TSCP,Phaco,Trab,Phaco-Trab,the IOP of PACG decreased,visual acuity improved,and the difference was statistically significant.After GDI,TSCP,Trab,Phaco-Trab,IOP of POAG decreased,after Phaco-Trab,visual acuity of POAG improved,and the difference was statistically significant.