关键词: 分级眼压管理, 原发性闭角型青光眼, 术后眼压, 视力, 视野缺损程度

Abstract: Objective　To explore the efficacy of graded intraocular pressure management on intraocular pressure management after surgery for primary angle closure glaucoma (PACG). Methods　The type of study was a prospective controlled study. Ninety-six patients with PACG who underwent surgery in Jinan Second People's Hospital from January 2020 to October 2021 were divided into a control group and a study group by the random number table method, with 48 cases in each group. The control group included 19 males and 29 females, with an age of (58.95±7.54) years old; the study group included 22 males and 26 females, with an age of (59.40±7.82) years old. The control group was given routine intraocular pressure management after surgery; the study group was given graded intraocular pressure management on the basis of non-pharmacologic intraocular pressure control strategies. The goal of intraocular pressure management was set as follows: compared with the baseline value before discharge, the increase rate was less than 20.0% or the absolute value of intraocular pressure was less than 18 mmHg (1 mmHg=0.133 kPa), without progression of visual field defects; the changes of intraocular pressure and progression of visual field defects were determined by follow-up, and the goal of graded intraocular pressure management was achieved by drugs. The intraocular pressures, visual acuity, and visual field defect degrees at baseline and 1, 3, and 6 months after surgery were compared between the two groups, and whether the intraocular pressure, visual acuity, and visual field defect degree were affected by the intervention method were analyzed. The measurement data were analyzed by independent sample t test or repeated-measures analysis of variance, and the count data were analyzed by χ² test. Results　The intraocular pressure of the study group was lower than that of the control group months after surgery [(15.04±2.97) mmHg vs. (16.48±3.39) mmHg], with a statistically significant difference (t=2.214, P=0.029), the visual acuity was higher than that of the control group [(0.59±0.14) vs. (0.51±0.16)], with a statistically significant difference (t=2.607, P=0.011), and the visual field defect degree of the study group was lower than the control group [(-4.32±0.66) dB vs. (-4.69±0.72) dB], with a statistically significant difference (t=2.625, P=0.010). Conclusion　Graded intraocular pressure management can effectively reduce the postoperative intraocular pressure level in PACG patients, and reduce the degrees of visual acuity loss and visual field defect.

Key words: Graded intraocular pressure management, Primary angle-closure glaucoma, Postoperative intraocular pressure, Visual acuity, Visual field defect degree