目的：分析年龄相关性白内障患者术后发生前房渗出的危险因素，并构建列线图模型。

方法：回顾性研究，收集2019年7月至2024年10月在本院进行手术的年龄相关性白内障患者450例467眼为研究对象，按照7：3的比例随机分为建模组(315例327眼)与验证组(135例140眼)，两组均根据术后是否发生前房渗出将其分为未渗出组与渗出组。收集患者临床基本资料； 多因素Logistic回归分析年龄相关性白内障患者术后发生前房渗出的影响因素； 年龄相关性白内障患者术后发生前房渗出的列线图模型采用R软件绘制； 列线图模型预测年龄相关性白内障患者术后发生前房渗出的校准度采用校准曲线、Hosmer-Lemeshow(H-L)检验评估； 利用ROC评估年龄相关性白内障患者术后发生前房渗出的效能。

结果：建模组与验证组间临床资料具有可比性。高度近视、葡萄膜炎病史、术前眼内压、晶状体核分级、术中超声累积能量复合参数、术中晶状体后囊膜破裂为年龄相关性白内障患者术后发生前房渗出的影响因素(均P<0.05)。建模组验证年龄相关性白内障患者术后发生前房渗出结果显示，ROC曲线下面积(AUC)为0.986(95%CI：0.966-0.996)，H-L检验为χ²=6.494，P=0.592，提示模型预测年龄相关性白内障患者术后发生前房渗出风险与实际风险有较好一致性。外部验证年龄相关性白内障患者术后发生前房渗出的AUC为0.982(95%CI：0.960-0.994)； 提示模型预测年龄相关性白内障患者术后发生前房渗出与实际风险有较好一致性(χ²=6.117，P=0.634)。

结论：高度近视、有葡萄膜炎病史、术前眼内压、晶状体核分级、术中超声累积能量复合参数、术中晶状体后囊膜破裂为年龄相关性白内障患者术后发生前房渗出的危险因素； 据此构建的列线图模型预测价值较高，可为个体化预防年龄相关性白内障术后发生前房渗出提供参考。

METHODS: Retrospective study. From July 2019 to October 2024, 450 patients(467 eyes)with age-related cataract who underwent surgery in our hospital were collected as the study subjects. They were randomly grouped into a modeling group(315 cases, 327 eyes)and a validation group(135 cases, 140 eyes)roughly estimated at a 7:3 ratio using the random number table method. Both groups were separated into a non-exudative group and an exudative group based on whether anterior chamber exudation occurred after surgery. Clinical basic data was collected; multivariate Logistic regression was applied to analyze the influencing factors of anterior chamber exudation in patients with age-related cataract after surgery; R software was applied to draw a nomogram prediction model of anterior chamber exudation in patients with age-related cataract after surgery; the calibration curve and Hosmer Lemeshow(H-L)test were applied to evaluate the calibration of the column plot model in predicting the occurrence of anterior chamber exudation in patients with age-related cataract after surgery; ROC was applied to evaluate the efficacy of anterior chamber exudation in patients with age-related cataract after surgery.

RESULTS:The clinical characteristics of the modeling group and the validation group were comparable. The high myopia, history of uveitis, preoperative intraocular pressure, lens nuclear grade, intraoperative cumulative dissipated energy, and intraoperative posterior capsular rupture of the lens were the influencing factors for postoperative anterior chamber exudation in patients with age-related cataract(all P<0.05). The results of the modeling group verifying the occurrence of anterior chamber exudation in patients with age-related cataract after surgery showed that the area under the ROC curve(AUC)was 0.986(95% CI: 0.966-0.996), the H-L test was χ²=6.494, P=0.592, indicating that the risk of anterior chamber exudation in patients with age-related cataract after surgery predicted by model had good consistency with actual risks, the AUC of postoperative anterior chamber exudation in patients with age-related cataract based on external validation was 0.982(95% CI: 0.960-0.994); and the H-L test suggested that the risk of anterior chamber exudation in CAT patients after surgery predicted by model had good consistency with actual risks(χ²=6.117, P=0.634).

CONCLUSION:High myopia, history of uveitis, preoperative intraocular pressure, lens nuclear grade, intraoperative cumulative dissipated energy, and intraoperative posterior capsular rupture of the lens are risk factors for postoperative anterior chamber exudation in patients with age-related cataract; the nomogram prediction model constructed based on this has high predictive value, and can provide reference for individualized prevention of anterior chamber exudation in patients with age-related cataract after surgery.