A Study On Surgical Options For Primary Angle Closure Glaucoma With Coexisting Cataract

Purpose: To investigate the role of the anterior segment characteristics in surgical options in primary angle closure glaucoma(PACG) patients with coexisting cataract.Methods: The ocular biometric parameters were compared between patients with cataract alone and patients with PACG with coexisting cataract. A initial prediction model was constructed using Fisher discrimant analysis. Stepwise binary Logistic regression modeling is applied to modify the initial model, and another group of patients were recruited to verify the specificity, sensitivity, compliance rate and the area under the ROC curve of this model.Results: There was significant difference in axial length, anterior chamber depth, vitreous chamber depth or lens thickness between cataract patients and those with PACG and cataract. The specificity, sensitivity, prediction compliance rate and area under the ROC curve of the logistic regression model were 82.02%, 78.57% , 80.59% , 87.6%, respectively. Applying the initial model, the absolute success rate of surgery were 91.67% and 97.14% in phacotrabeculectomy and phaco-goniosynechialysis, respectively, in three months after surgery, while the specificity, sensitivity, prediction compliance rate and area under the ROC curve were 86.41%,84.31%,85.66%,92.8%, respectively.Conclusions: The specificity, sensitivity, prediction compliance rate and the area under the ROC curve of the Logistic regression model are all clinically significant. The results show that the prediction model provides a reliable theoretical basis for clinical application.