Objective To investigate the relationship of serum melatonin(MLT)and Klotho protein with pro-inflammatory factors and the effect of surgical treatment in patients with primary angle-closure glaucoma(PACG).Methods A total of 149 PACG patients admitted to the Zigong Fourth People's Hospital from June 2018 to June 2021 were selected as the case group,and 149 healthy people who underwent physical examina-tion in the hospital during the same period were selected as the control group.The levels of MLT,Klotho pro-tein,interleukin-6(IL-6),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)were compared be-tween the two groups.Pearson correlation analysis was used to analyze the correlation between MLT,Klotho protein and pro-inflammatory factors.Univariate and multivariate Logistic regression models were used to an-alyze the influencing factors of surgical treatment.Results Compared with the control group,the levels of MLT and Klotho protein in the case group were decreased(P<0.05),and the levels of IL-1β,IL-6 and TNF-α were increased(P<0.05).Pearson correlation analysis showed that serum MLT and Klotho protein were negatively correlated with the levels of pro-inflammatory factors IL-1β,IL-6,and TNF-α(P<0.05).After 12 months of surgical treatment,30 patients(20.13%)had no effect of surgical treatment(ineffective group).119 patients(79.87%)had effective surgical treatment(effective group).The univariate analysis showed that compared with the effective group,the preoperative intraocular pressure(IOP),proportion of chronic PACG,preoperative best corrected visual acuity,proportion of preoperative Angle adhesion>160° were significantly increased(P<0.05),and the preoperative anterior chamber depth,MLT,and Klotho protein levels were de-creased in the ineffective group(P<0.05).Multivariate Logistic regression analysis showed that elevated pre-operative IOP,chronic PACG,decreased MLT and Klotho levels were independent risk factors for ineffective surgical treatment(P<0.05).Conclusion serum MLT,Klotho protein levels in patients with PACG,closely associated with proinflammatory factor,is the related factors influencing the effect of surgical treatment.