Establishment of a Nomogram Model to Predict Glaucoma After Cataract Extraction in Children and Its Efficacy Evaluation
Objective To establish a nomogram model for predicting glaucoma after cataract extraction in children,and to evaluate its efficacy.Methods The clinical data of 352 cases of 624 children with cataract extraction treated in the First Affiliated Hospital of Zhengzhou University from January 2019 to September 2023 were retrospectively analyzed.According to the occurrence of postoperative glaucoma,the patients were divided into glaucoma group and non-glaucoma group.The patients were followed up for 6 months to 4.5 years to record the occurrence of postoperative glaucoma.The factors influencing the occurrence of postoperative glaucoma after cataract extraction were analyzed by univariate and multivariate logistic regression,and a nomogram prediction model for postoperative glaucoma was constructed based on the results of multivariate analysis.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of the model,and the predictive efficiency of the model was evaluated and verified.Results A total of 46 cases of postoperative glaucoma occurred in 352 children from 6 months to 4.5 years after operation,the incidence rate was 13.07％.The age of operation of the glaucoma children[(5.82±1.90)months]was earlier than that of the non-glaucoma group[(7.82±2.56)months].The proportion of children with nuclear cataract,other congenital eye abnormalities,family history of congenital cataract,corneal diameter ≤10 mm,number of intraocular operations＞1 time,the central corneal thickness(CCT)increased one month after surgery,and the proportion of postpupillary iris adhesion was higher than that in the non-glaucoma group,the differences were statistically significant(P＜0.05).Logistic regression analysis showed that surgical age,nuclear cataract,and other congenital ocular abnormalities,family history of congenital cataract,corneal diameter ≤10 mm,increased CCT 1 month after surgery and posterior iris adhesion of pupil margin were independent factors associated with glaucoma after cataract extraction in children(P＜0.05).The C-index of the nomogram model was 0.817,and the ROC curve showed that the area under the curve(AUC)of the model predicting postoperative glaucoma was 0.817,calibration curve and clinical impact curve evaluation results showed that the model has good application value and positive clinical net benefit.Conclusion Surgical age,nuclear cataract,congenital abnormalities associated with other eyes,family history of congenital cataract,corneal diameter ≤ 10 mm,increased CCT 1 month after surgery,and postoperative adhesion of posterior iris margin are independent factors for secondary glaucoma after cataract extraction in children.Building a nomogram model based on the above factors has certain value in predicting postoperative glaucoma,and has good differentiation,calibration and practicability.It can be used as an effective model for predicting postoperative glaucoma,and has certain guiding value for clinical prevention and treatment of this disease.
万方数据
维普
