1980 - 2004年白内障摘除术后视网膜脱离的风险：一项基于人群的研究。
Risk of retinal detachment after cataract extraction, 1980-2004: a population-based study.
作者信息
Erie Jay C, Raecker Matthew E, Baratz Keith H, Schleck Cathy D, Robertson Dennis M
机构信息
Departments of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
出版信息
Trans Am Ophthalmol Soc. 2006;104:167-75.
PURPOSE
To estimate the long-term cumulative risk of retinal detachment (RD) after cataract extraction.
METHODS
Using the resources of the Rochester Epidemiology Project, we retrospectively identified all residents of Olmsted County, Minnesota, who had cataract extraction from 1980 through 2004 (10,256 cataract extractions in 7,137 residents) and were diagnosed with RD. The observed probability of RD after cataract extraction was estimated using the Kaplan-Meier method. A cumulative probability ratio of RD after cataract extraction was determined by comparing the observed probability of RD with the expected probability of RD in residents without cataract extraction. Two controls chosen from the primary cataract surgery cohort were matched to each RD case by age, sex, and duration of follow-up. Logistic regression models assessed differences between cases and controls.
RESULTS
Eighty-two cases of RD after cataract extraction were identified. The cumulative probability of RD after extracapsular cataract extraction (ECCE) and phacoemulsification was 0.27%, 0.71%, 1.23%, 1.58%, and 1.79% at 1, 5, 10, 15, and 20 years after surgery. There was no significant difference in the probability of RD after ECCE when compared to phacoemulsification (P =.13). The cumulative probability ratio of RD at 20 years after ECCE and phacoemulsification was four times (95% CI, 2.6-5.4) higher than would be expected in a similar group of residents not undergoing cataract extraction (P <.001). Males, younger age, myopia, and increased axial length were significantly associated with RD (P <.001).
CONCLUSIONS
The cumulative risk of RD after ECCE and phacoemulsification is increased for up to 20 years after surgery.
目的
评估白内障摘除术后视网膜脱离（RD）的长期累积风险。
方法
利用罗切斯特流行病学项目的资源，我们回顾性地确定了明尼苏达州奥尔姆斯特德县1980年至2004年期间接受白内障摘除术（7137名居民中的10256例白内障摘除术）并被诊断为RD的所有居民。使用Kaplan-Meier方法估计白内障摘除术后RD的观察概率。通过比较白内障摘除术后RD的观察概率与未接受白内障摘除术居民的预期RD概率，确定白内障摘除术后RD的累积概率比。从原发性白内障手术队列中选择的两名对照与每例RD病例按年龄、性别和随访时间进行匹配。逻辑回归模型评估病例与对照之间的差异。
结果
共确定了82例白内障摘除术后RD病例。囊外白内障摘除术（ECCE）和超声乳化术后1、5、10、15和20年RD的累积概率分别为0.27%、0.71%、1.23%、1.58%和1.79%。与超声乳化术相比，ECCE术后RD的概率无显著差异（P = 0.13）。ECCE和超声乳化术后20年RD的累积概率比是未接受白内障摘除术的类似居民组预期概率的四倍（95%CI，2.6 - 5.4）（P < 0.001）。男性、年轻、近视和眼轴长度增加与RD显著相关（P < 0.001）。
结论
ECCE和超声乳化术后RD的累积风险在术后长达20年都有所增加。
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