Supuk Elvira, Alderson Alison, Davey Christopher J, Green Clare, Litvin Norman, Scally Andrew J, Elliott David B
Bradford School of Optometry and Vision Science, University of Bradford, West Yorkshire, UK.
Ophthalmology Department, Bradford Teaching Hospitals Foundation Trust, West Yorkshire, UK.
Ophthalmic Physiol Opt. 2016 Mar;36(2):183-90. doi: 10.1111/opo.12243. Epub 2015 Nov 9.
To determine whether dizziness and falls rates change due to routine cataract surgery and to determine the influence of spectacle type and refractive factors.
Self-reported dizziness and falls were determined in 287 patients (mean age of 76.5 ± 6.3 years, 55% females) before and after routine cataract surgery for the first (81, 28%), second (109, 38%) and both eyes (97, 34%). Dizziness was determined using the short-form of the Dizziness Handicap Inventory. Six-month falls rates were determined using self-reported retrospective data.
The number of patients with dizziness reduced significantly after cataract surgery (52% vs 38%; χ(2) = 19.14(,) p < 0.001), but the reduction in the number of patients who fell in the 6-months post surgery was not significant (23% vs 20%; χ(2) = 0.87, p = 0.35). Dizziness improved after first eye surgery (49% vs 33%, p = 0.01) and surgery on both eyes (58% vs 35%, p < 0.001), but not after second eye surgery (52% vs 45%, p = 0.68). Multivariate logistic regression analyses found significant links between post-operative falls and change in spectacle type (increased risk if switched into multifocal spectacles). Post-operative dizziness was associated with changes in best eye visual acuity and changes in oblique astigmatic correction.
Dizziness is significantly reduced by first (or both) eye cataract surgery and this is linked with improvements in best eye visual acuity, although changes in oblique astigmatic correction increased dizziness. The lack of improvement in falls rate may be associated with switching into multifocal spectacle wear after surgery.
确定常规白内障手术是否会导致头晕和跌倒发生率发生变化，并确定眼镜类型和屈光因素的影响。
对287例患者（平均年龄76.5±6.3岁，55%为女性）在首次（81例，28%）、第二次（109例，38%）及双眼（97例，34%）常规白内障手术前后进行自我报告的头晕和跌倒情况调查。使用头晕残障量表简表来确定头晕情况。通过自我报告的回顾性数据确定六个月内的跌倒发生率。
白内障手术后头晕患者数量显著减少（52%对38%；χ²=19.14，p<0.001），但术后6个月内跌倒患者数量的减少不显著（23%对20%；χ²=0.87，p=0.35）。单眼手术后头晕情况有所改善（49%对33%，p=0.01），双眼手术后也有所改善（58%对35%，p<0.001），但第二次单眼手术后未改善（52%对45%，p=0.68）。多因素逻辑回归分析发现术后跌倒与眼镜类型的变化之间存在显著关联（换成多焦点眼镜会增加风险）。术后头晕与最佳矫正视力的变化以及斜轴散光矫正的变化有关。
单眼（或双眼）白内障手术可显著降低头晕发生率，这与最佳矫正视力的改善有关，尽管斜轴散光矫正的变化会增加头晕发生率。跌倒发生率未改善可能与术后换成多焦点眼镜佩戴有关。
