HV Desai Eye Hospital, Pune, India.
J Cataract Refract Surg. 2011 Feb;37(2):328-34. doi: 10.1016/j.jcrs.2010.08.034.
To determine whether routine monitoring leads to better visual outcomes over time after cataract surgery.
Comprehensive community eyecare center in western India.
Comparative case series.
Operative case sheets of all patients having cataract surgery were collected. Preoperative information, surgical details, and follow-up findings were included in the audit. The outcome measure was postoperative corrected distance visual acuity (CDVA), which was graded as good (≥ 6/18), borderline, or poor (<6/60). If the outcome was poor, the causes were classified as follows: selection, surgery, spectacles, or sequelae. The surgeons were briefed about their performance twice a year.
The audit included 16,382 cataract surgeries. The proportion of eyes having a CDVA of 6/18 or better 6 weeks postoperatively improved significantly, from 86.5% (95% confidence interval [CI], 84.8%-88.3%) in 2002 to 90.5% (95% CI, 89.3%-91.8%) in 2005, while CDVA worse than 6/60 declined from 5.9% in 2002 to 2.5% in 2005. Manual small-incision cataract surgery was more popular than conventional extracapsular cataract surgery in 2004 and 2005. The incidence of posterior capsule tear and vitreous loss declined in the later years, although the rate of striate keratitis remained the same. Younger patients, women, those without ocular comorbidity, and those with a preoperative CDVA of better than 6/60 had better visual acuity 8 weeks postoperatively.
Routine monitoring and modernization of technique helped increase good visual outcomes and reduce poor visual outcomes after cataract surgery.
确定白内障手术后定期监测是否能随着时间的推移改善视力结果。
印度西部综合性社区眼科保健中心。
对比病例系列。
收集所有行白内障手术患者的手术记录单。审核内容包括术前信息、手术细节和随访结果。术后视力的衡量标准是矫正后视力（CDVA），分为好（≥6/18）、边缘、差（<6/60）。如果结果差，则将原因分为选择、手术、眼镜和后遗症。每年对医生进行两次培训。
本研究共纳入 16382 例白内障手术。术后 6 周时，视力≥6/18 的眼比例明显提高，从 2002 年的 86.5%（95%置信区间[CI]，84.8%-88.3%）提高到 2005 年的 90.5%（95% CI，89.3%-91.8%），而视力差于 6/60 的比例从 2002 年的 5.9%下降到 2005 年的 2.5%。手动小切口白内障手术在 2004 年和 2005 年比传统囊外白内障手术更受欢迎。尽管条纹状角膜炎的发生率保持不变，但后囊膜破裂和玻璃体丢失的发生率在随后几年有所下降。年轻患者、女性、无眼部合并症以及术前 CDVA 较好（>6/60）的患者术后 8 周视力更好。
定期监测和技术现代化有助于提高白内障手术后的良好视力结果，减少不良视力结果。
