[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).