Castells X, Alonso J, Ribó C, Casado A, Buil J A, Badia M, Castilla M
Health Services Research Unit, Institut Municipal d'Investigació Mèdica, Barcelona, Spain.
Ophthalmology. 1999 Apr;106(4):676-82. doi: 10.1016/S0161-6420(99)90150-1.
To compare the outcomes of second eye cataract surgery with those of first eye surgery. In particular, to evaluate changes in visual acuity (VA), visual function, and health status after the first and second eye surgeries.
A cohort (case series) analysis of patients recruited in a clinical trial.
A total of 403 consecutive patients with indication of noncombined first eye or second eye cataract surgery were recruited in 3 public hospitals in Barcelona, Spain. First eye surgery patients are compared to second eye surgery patients.
Patients were evaluated both before surgery and 4 months after surgery by a standardized telephone interview and clinical examination.
Visual acuity, visual function index (VF-14), a 14-item instrument designed to measure visual function, and the Sickness Impact Profile (SIP), a generic measure of health status.
Full data were obtained from 315 (78%) patients: 249 who underwent first eye surgery only and 66 different patients who underwent second eye surgery. Significant improvement was found in both groups of patients for best-corrected VA in the operated eye (4.4 Snellen lines, P < 0.001; 4.2 Snellen lines, P < 0.001, respectively), VA in the better eye (2.8 Snellen lines, P < 0.001; 1.4 Snellen lines, P < 0.001), and visual function (26.3 Snellen lines, P < 0.001; 17.0 Snellen lines; P < 0.001). Four months after the operation, the VF-14 of the second eye group was slightly better (93.4 vs. 88.5; P = 0.09; score range: 0, worst, to 100, best). Psycho-social SIP scores improved in both groups (4.8, P < 0.001; 3.1, P = 0.016). Physical SIP score improved only in the first eye surgery group (1.8, P = 0.003) but not in the second eye surgery group (-1.0, P = 0.338; score range: 0, best, to 100, worst).
The results of our study suggest that patients undergoing second eye cataract surgery show significant improvements in VA, visual function, and psycho-social health status. However, global and physical health status does not change after second eye cataract surgery.
比较第二眼白内障手术与第一眼手术的结果。特别是评估第一眼和第二眼手术后视力（VA）、视觉功能和健康状况的变化。
对一项临床试验中招募的患者进行队列（病例系列）分析。
在西班牙巴塞罗那的3家公立医院共招募了403例有非联合第一眼或第二眼白内障手术指征的连续患者。将第一眼手术患者与第二眼手术患者进行比较。
通过标准化电话访谈和临床检查在手术前和手术后4个月对患者进行评估。
视力、视觉功能指数（VF - 14，一种用于测量视觉功能的14项指标工具）以及疾病影响概况量表（SIP，一种通用的健康状况测量工具）。
从315例（78%）患者中获得了完整数据：249例仅接受了第一眼手术，66例不同患者接受了第二眼手术。两组患者手术眼的最佳矫正视力（分别为4.4行Snellen视力表，P < 0.001；4.2行Snellen视力表，P < 0.001）、较好眼的视力（2.8行Snellen视力表，P < 0.001；1.4行Snellen视力表，P < 0.001）和视觉功能（26.3行Snellen视力表，P < 0.001；17.0行Snellen视力表；P < 0.001）均有显著改善。手术后4个月，第二眼组的VF - 14略好（93.4对88.5；P = 0.09；评分范围：0为最差，100为最佳）。两组的心理社会SIP评分均有所改善（4.8，P < 0.001；3.1，P = 0.016）。身体SIP评分仅在第一眼手术组有所改善（1.8，P = 0.003），而在第二眼手术组未改善（-1.0，P = 0.338；评分范围：0为最佳，100为最差）。
我们的研究结果表明，接受第二眼白内障手术的患者在视力、视觉功能和心理社会健康状况方面有显著改善。然而，第二眼白内障手术后整体和身体健康状况没有变化。
