Curtin-Monash Accident Research Centre, School of Public Health, Curtin University, Perth, Western Australia, Australia.
Acta Ophthalmol. 2013 Sep;91(6):e445-9. doi: 10.1111/aos.12124. Epub 2013 Apr 16.
Cataract is the leading cause of reversible blindness worldwide, and the incidence of cataract surgery is projected to increase as the population ages. Gaining an understanding of the effects of cataract surgery on a range of health outcomes is important for maintaining the health and safety of older adults.
A before and after cohort study was conducted using the Western Australian Hospital Morbidity Data System, Mental Health Information System and the Western Australian Death Registry.
Of the 21 110 patients who underwent cataract surgery in one eye only, 295 had mental health contacts for depression and/or anxiety 1 year before (n = 158) or 1 year after (n = 137) surgery. Results from Poisson generalized estimating equations showed a significant decrease of 18.80% (p ≤ 0.001) in the number of mental health contacts for depression and/or anxiety the year after cataract surgery after accounting for potential confounding factors. A 27.46% increase in mental health contacts the year after cataract surgery was reported by women compared with men (95% CI: 1.08-1.50). Those living in remote areas had less contact with mental health services compared with those living in metropolitan areas (adjusted risk ratio 0.62, 95% CI: 0.46-0.84). The corresponding reduction in health care costs for treatment of depression and/or anxiety was 28%.
Further research should be conducted to collect information on the utilization of health care resources not captured in this study, namely community-based services, visits to general practitioners and/or emergency departments as well as medication usage such as antidepressants.
白内障是全球可致盲的首要原因，且随着人口老龄化，白内障手术的发病率预计将会增加。了解白内障手术对一系列健康结果的影响，对于维护老年人的健康和安全非常重要。
使用西澳大利亚州医院发病率数据系统、心理健康信息系统和西澳大利亚州死亡登记处，开展了一项前后对照队列研究。
在仅单眼接受白内障手术的 21110 名患者中，有 295 名在手术前 1 年（n=158）或手术后 1 年（n=137）有心理健康方面的抑郁和/或焦虑接触史。泊松广义估计方程的结果表明，在考虑到潜在混杂因素后，手术后 1 年因抑郁和/或焦虑而进行心理健康咨询的次数显著减少了 18.80%（p≤0.001）。与男性相比，女性在白内障手术后 1 年报告心理健康咨询接触增加了 27.46%（95%CI：1.08-1.50）。与居住在大都市区的人相比，居住在偏远地区的人接受心理健康服务的机会较少（调整后的风险比为 0.62，95%CI：0.46-0.84）。治疗抑郁和/或焦虑的医疗保健费用相应减少了 28%。
应进一步开展研究，收集本研究未捕获的卫生保健资源利用信息，即社区服务、全科医生和/或急诊就诊以及抗抑郁药等药物使用情况。
