Objective: To analyze the disease composition and primary surgical procedures in pediatric inpatients with secondary glaucoma. Methods: A retrospective case series study was conducted. Clinical data of children aged≤16 years with secondary glaucoma who were admitted to the Zhongshan Ophthalmic Center, Sun Yat-sen University, between January 1, 2017, and December 31, 2021, were included. The patients were classified according to the Childhood Glaucoma Research Network (CGRN) classification system, and their diagnoses, underlying factors, gender, age of onset, affected eye(s), age and type of initial surgery, and ophthalmic examination data were analyzed. Statistical analysis was performed using Kruskal-Wallis rank sum test and χ2 test. Results: A total of 540 patients (744 eyes) were included in this study, comprising 319 males (59.1%) and 221 females (40.9%). Unilateral disease was observed in 336 cases (62.2%), while bilateral involvement was present in 204 cases (37.8%). The age of onset was 4.0 (0.0, 9.0) years, and the median age of the first anti-glaucoma surgery was 5.0 (0.7, 10.0) years. Among them, there were 195 cases (36.1%) of secondary glaucoma associated with non-acquired ocular anomalies (SCG-O), with a median age of onset of 0.0 (0.0, 4.0) years, and 97 of these cases (49.7%) were male. secondary glaucoma associated with non-acquired systemic disease or syndrome (SCG-S) were observed in 68 cases (12.6%), with a median age of glaucoma onset of 0.1 (0.0, 4.0) years, and 47 of these cases (69.1%) were male. Secondary glaucoma associated with acquired conditions (SCG-A) accounted for 192 cases (35.6%), with a median age of onset of 9.0 (5.0, 13.0) years, and 125 of these cases (65.1%) were male. There were 85 cases (15.7%) of secondary glaucoma following cataract surgery (SCG-C), with a median age of onset of 3.0 (0.8, 7.0) years, and 50 of these cases (58.8%) were male. Male patients were predominant in SCG-S and SCG-A, with 47 cases (69.1%) and 125 cases (65.1%), respectively (χ2=9.94, 17.52; P=0.002,<0.001). Except for SCG-O, all other types of pediatric secondary glaucoma predominantly affected only one eye: SCG-S in 52 cases (76.5%), SCG-A in 128 cases (66.7%), and SCG-C in 54 cases (63.5%) (χ2=19.06, 21.33, 6.22; all P<0.05). The highest proportion of SCG-O was attributed to congenital ectropion uveae (46 cases, 23.6%). Sturge-Weber syndrome was the most common SCG-S (45 cases, 66.3%), while SCG-A mostly resulted from trauma (59 cases, 30.8%) and corticosteroid use (56 cases, 29.2%). Trabeculectomy (211 eyes, 30.8%) and glaucoma drainage device implantation (197 eyes, 28.7%) were the most frequently performed primary surgical procedures. Conclusions: SCG-O and SCG-A were found to be common types of pediatric secondary glaucoma. The age of onset and the choice of primary anti-glaucoma surgical procedures varied among different types of pediatric secondary glaucoma. However, overall, trabeculectomy and glaucoma drainage device implantation were the primary surgical procedures predominantly employed.
目的： 分析儿童继发性青光眼住院患者疾病类型构成及首次手术方式。 方法： 回顾性病例系列研究。纳入2017年1月1日至2021年12月31日于中山大学中山眼科中心住院治疗的16岁及以下儿童继发性青光眼患者的临床资料，依据儿童青光眼研究网络（CGRN）分类系统分类，并分析其诊断及继发因素、性别、发病年龄、受累眼别、首次手术年龄及类型、眼科检查资料。采用Kruskal-Wallis秩和检验和χ2检验进行统计学分析。 结果： 共纳入540例（744只眼）患者，其中男性319例（59.1%），女性221例（40.9%）。单眼发病336例（62.2%），双眼发病204例（37.8%）。发病年龄为4.0（0.0，9.0）岁，首次行抗青光眼手术的年龄为5.0（0.7，10.0）岁。其中非获得性眼部异常继发性青光眼195例（36.1%），中位发病年龄0.0（0.0，4.0）岁，男性97例（49.7%）；非获得性全身疾病或综合征继发性青光眼68例（12.6%），中位青光眼发病年龄0.1（0.0，4.0）岁，男性47例（69.1%）；获得性疾病继发性青光眼192例（35.6%），中位发病年龄9.0（5.0，13.0）岁，男性125例（65.1%）；白内障摘除手术后继发性青光眼占85例（15.7%），中位发病年龄3.0（0.8，7.0）岁，男性50例（58.8%）。非获得性全身疾病或综合征继发性青光眼和获得性疾病继发性青光眼以男性患者为主，分别为47例（69.1%）和125例（65.1%）（χ2=9.94，17.52；P=0.002，<0.001）。除非获得性眼部异常继发性青光眼外，其余类型的儿童继发性青光眼均以单眼发病为主：非获得性全身疾病或综合征继发性青光眼为52例（76.5%），获得性疾病继发性青光眼为128例（66.7%），白内障摘除手术后继发性青光眼为54例（63.5%）（χ2=19.06，21.33，6.22；均P<0.05）。非获得性眼部异常继发性青光眼以先天性葡萄膜外翻占比最高［46例（23.6%）］；非获得性全身疾病或综合征继发性青光眼以斯德奇-韦伯综合征多见［45例（66.3%）］；获得性疾病继发性青光眼多继发于外伤［59例（30.8%）］和使用糖皮质激素［56例（29.2%）］。小梁切除术［211只眼（30.8%）］和青光眼引流阀植入术［197只眼（28.7%）］为占比最高的首次手术方式。 结论： 儿童继发性青光眼中以非获得性眼部异常继发性青光眼和获得性疾病继发性青光眼为常见的类型；不同类型的儿童继发性青光眼发病年龄以及主要首次抗青光眼术式选择有所不同，但整体上以小梁切除术和青光眼引流阀植入术为主。.