Moorman C, Sommer A, Stark W, Enger C, Payne J, Maumenee A E
Dana Center for Preventive Ophthalmology, Wilmer Institute and School of Public Health, Johns Hopkins University, Baltimore, Md.
Ophthalmic Surg. 1990 Nov;21(11):761-6.
To examine changes in indications for cataract surgery which have contributed to the increasing rate of cataract extractions, we compared preoperative characteristics of 265 patients who had undergone surgery in 1988 with a similar number who had undergone surgery by the same four ophthalmologists in 1974 and 1982. Between 1974 and 1988 the number of extractions performed annually by two high-referral hospital-based surgeons rose by 68%. Over 90% of these procedures in 1974 were intracapsular extractions; in 1988, 90% were extracapsular extractions with intraocular lenses. In 1988, preoperative visual acuity was better in both the study eyes and the fellow eyes, the proportion of those with acuities better than 20/60 having risen from 10% to 21%, and from 49% to 67%, respectively. The proportion of patients waiting more than 2 years for surgery on the second eye doubled between 1974 and 1988. These changes, already evident by 1982 for the hospital-based surgeons, became characteristic of the community-based surgeons' practices as well between 1982 and 1988.
为研究导致白内障摘除率上升的白内障手术适应证的变化，我们比较了1988年接受手术的265例患者的术前特征与1974年和1982年由同四位眼科医生进行手术的类似数量患者的术前特征。1974年至1988年期间，两位以高转诊率医院为基础的外科医生每年进行的摘除手术数量增加了68%。1974年，这些手术中超过90%是囊内摘除术；1988年，90%是带人工晶状体的囊外摘除术。1988年，研究眼和对侧眼的术前视力均有所提高，视力优于20/60的患者比例分别从10%升至21%，从49%升至67%。1974年至1988年期间，等待另一只眼睛手术超过2年的患者比例翻了一番。这些变化在1982年时已在以医院为基础的外科医生中明显出现，在1982年至1988年期间也成为了以社区为基础的外科医生的手术特点。
