Freeman Ellen E, Roy-Gagnon Marie-Hélène, Fortin Eric, Gauthier Danny, Popescu Mihaela, Boisjoly Hélène
Department of Ophthalmology, University of Montreal, Montreal, Quebec H1T 2M4, Canada.
Arch Ophthalmol. 2010 Feb;128(2):230-4. doi: 10.1001/archophthalmol.2009.380.
To estimate the annual incidence of endophthalmitis after cataract surgery from January 1, 1996, through December 31, 2005, in Quebec, Canada.
Deidentified data were obtained from an outpatient physician billing database (Quebec State Control for Health Insurance [RAMQ]) with regard to all cataract surgical procedures performed from January 1, 1996, through December 31, 2005, in Quebec. For this cohort, records of an International Classification of Diseases, Ninth Revision (ICD-9) code for endophthalmitis during the same years were requested from 2 sources: the RAMQ outpatient database and an inpatient hospital discharge database (Maintenance and Exploitation of Data for the Study of Hospitalized Patients [MED-ECHO]). Endophthalmitis after cataract surgery was assumed if it occurred within 90 days of the surgery. Risk factors were examined using chi(2) tests and logistic regression.
After exclusions, 490 690 cataract surgical procedures were performed from January 1, 1996, through December 31, 2005. A total of 754 cases of endophthalmitis occurred within 90 days after surgery for an overall incidence rate of 1.5 per 1000 surgical procedures (95% confidence interval [CI], 1.4-1.7). Factors associated with endophthalmitis included age of 85 years or older (odds ratio [OR], 1.34; 95% CI, 1.06-1.70), male sex (1.44; 1.24-1.66), later year of surgery (0.94; 0.92-0.97), and region of cataract surgery, because regions 6 (2.21; 1.91-2.55) and 9 (4.00; 2.48-6.43) had higher rates compared with all other regions.
Reasons that explain the apparent decrease in endophthalmitis, especially in 2005, should be explored and further research performed to understand why certain patients and regions have higher risks of endophthalmitis after cataract surgery.
评估1996年1月1日至2005年12月31日期间加拿大魁北克白内障手术后眼内炎的年发病率。
从门诊医生计费数据库（魁北克省医疗保险控制局[RAMQ]）获取1996年1月1日至2005年12月31日在魁北克进行的所有白内障手术的匿名数据。对于该队列，从两个来源获取同年国际疾病分类第九版（ICD-9）眼内炎代码记录：RAMQ门诊数据库和住院医院出院数据库（住院患者研究数据维护与利用[MED-ECHO]）。如果白内障手术后90天内发生眼内炎，则假定为白内障手术后眼内炎。使用卡方检验和逻辑回归检查危险因素。
排除后，1996年1月1日至2005年12月31日共进行了490690例白内障手术。术后90天内共发生754例眼内炎，总体发病率为每1000例手术1.5例（95%置信区间[CI]，1.4 - 1.7）。与眼内炎相关的因素包括年龄85岁及以上（比值比[OR]，1.34；95%CI，1.06 - 1.70）、男性（1.44；1.24 - 1.66）、手术年份较晚（0.94；0.92 - 0.97）以及白内障手术地区，因为6区（2.21；1.91 - 2.55）和9区（4.00；2.48 - 6.43）的发病率高于所有其他地区。
应探究解释眼内炎明显下降的原因，尤其是2005年的情况，并开展进一步研究以了解为何某些患者和地区白内障手术后发生眼内炎的风险更高。
