Lundström Mats, Behndig Anders, Montan Per, Artzén Ditte, Jakobsson Gunnar, Johansson Björn, Thorburn William, Stenevi Ulf
EyeNet Sweden, Blekinge Hospital, SE-371 85 Karlskrona, Sweden.
J Cataract Refract Surg. 2009 Oct;35(10):1679-87.e1. doi: 10.1016/j.jcrs.2009.05.025.
To report the selection procedure of complicated and uneventful cataract extractions included in the Swedish Capsule Rupture Study and to describe the additional care required after a capsule complication during cataract surgery.
Ten ophthalmic surgery departments in Sweden.
Consecutive cataract extractions with a reported capsule complication were selected from the national database. Surgical data and data from the matching ophthalmic records at the participating clinics were analyzed. Controls were selected as the first uneventful procedure in the database after each procedure with a complication.
Data on 655 cataract extractions were studied for evaluation of risks and additional care; a capsule complication occurred in 324 procedures and no complication in 331 procedures. Using these records, 369 patients were recruited for a follow-up examination of the outcomes 3 years after the original cataract extraction. The records showed a substantial increase in additional care after a capsule complication, including more visits after surgery, increased need for in-patient care, and a significantly greater percentage of reoperations than after the uneventful surgery. With additional care, the average cost of a procedure with a capsule complication was approximately double the cost of an uneventful cataract extraction.
The combined study of the database and matching medical records showed a substantial increase in additional care after a capsule complication. Using the database allowed identification of a large number of capsule complication cases and uneventful cases, indicating that national databases are excellent sources of data for studying unusual complications.
报告瑞典囊膜破裂研究中复杂及顺利的白内障摘除术的选择过程，并描述白内障手术中发生囊膜并发症后所需的额外护理。
瑞典的十个眼科手术科室。
从国家数据库中选取报告有囊膜并发症的连续白内障摘除术病例。分析手术数据以及参与诊所匹配的眼科记录中的数据。对照组选取为数据库中每次出现并发症的手术之后的首例顺利手术。
对655例白内障摘除术的数据进行研究以评估风险和额外护理情况；324例手术发生了囊膜并发症，331例手术未发生并发症。利用这些记录，招募了369例患者在初次白内障摘除术后3年进行结局随访检查。记录显示囊膜并发症后额外护理大幅增加，包括术后就诊次数增多、住院护理需求增加，以及再次手术的比例显著高于顺利手术。经过额外护理，发生囊膜并发症的手术平均费用约为顺利白内障摘除术费用的两倍。
数据库与匹配医疗记录的联合研究显示囊膜并发症后额外护理大幅增加。利用该数据库能够识别大量囊膜并发症病例和顺利病例，表明国家数据库是研究罕见并发症的优质数据来源。
