| Purpose To observe the changes of intraocular pressure,visual acuity,visual field,and pattern-reversal visual evoked potential(PVEP)in patients with primary angle-closure glaucoma(PACG)after glaucoma surgery.And to explore the causes of their changes and related factors,and whether there is any correlation between them.Methods This was a prospective study.PACG patients who underwent antiglaucoma surgeries in our hospital from December 2017 to December 2018 and had good intraocular pressure(IOP)control during postoperative follow-up visits were selected.Multiple exclusion criteria were set to exclude other factors that may affect visual field(VF)and PVEP outcomes.After admission,patients were given appropriate medication according to their IOP,and general check-ups and ophthalmic examinations were performed.Glaucoma specialist examinations included: binocular slit lamp microscopy,IOP,anterior chamber gonioscopic examination,fundus examination,optometry,axial length,ultrasound biomicroscopy,Humphrey standard automatic visual field examination,and PVEP examination.Among them,the mean defect(MD)value and pattern standard deviation(PSD)value of VF were documented,as well as the latency and amplitude of the P100 wave in the 1° square and 0.25° square PVEP reactions.Trabeculectomy or YAG laser peripheral iridotomy was performed according to the patient’s condition.The timing of the three follow-up visits were 1 week after discharge,about 1 month after discharge(about 40 days after surgery),and about 3 months after surgery.At the 2nd and 3rd follow-up visits,the VF and PVEP examinations were performed.The collected eyes were divided into groups in two ways.Firstly,they were divided into acute angle-closure glaucoma group(Group A),chronic angleclosure glaucoma group(Group C)and postoperative uncontrolled glaucoma group(Group P).In addition,according to the IOP at admission,they were divided into Group 1(IOP ≥ 32 mm Hg),Group 2(IOP between 22 mm Hg and 31 mm Hg),and Group 3(IOP ≤ 21 mm Hg).Non-parametric tests and Spearman correlation analysis were performed on the collected data using the SPSS program,and P < 0.05 was considered as statistically significant.Results A total of 58 eyes of 50 patients were collected,including 34 eyes with acute angle-closure glaucoma,18 eyes with chronic angle-closure glaucoma,and 6 postoperative eyes with uncontrolled glaucoma.26 eyeswere put in Group 1,and 12 eyes in Group 2,and 20 eyes in Group 3.1.There were significant differences between the IOP values of different follow-up within Group 1,2,A and C.There was no significant difference within Group 3 and P.2.The best corrected visual acuity of the patients after surgery has an improvement trend,especially in the group 1 and A.3.Except for Group P,the absolute value of MD values in each group decreased,and the difference was statistically significant;the change of PSD value was not statistically significant 4.The latency and amplitude of the P100 wave of each group were analyzed.There was no significant difference in the P100 wave latency between each follow-up.Except for Group P,the amplitude of P100 wave in the second and third follow-up of each group increased compared with that before surgery,and the difference was statistically significant.5.Spearman correlation coefficient was used to analyze the correlation between the MD value of VF and the PVEP outcomes.It was found that there was a strong negative correlation between the absolute value of MD values and the amplitude of the P100 wave.Conclusions 1.In patients with PACG who had good IOP control after glaucoma surgeries,the MD of VF and amplitude of PVEP P100 wave could improve compared to the preoperative value,and the change was statistically significant.2.For patients with PACG,surgical treatment can remedy the patient’s visual function.3.The PVEP test results have a good correlation with the VF examination and can be used to monitor the progress of glaucoma patients. |
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