Mohammadi Seyed-Farzad, Hashemi Hassan, Mazouri Arash, Rahman-A Nazanin, Ashrafi Elham, Mehrjardi Hadi Z, Roohipour Ramak, Fotouhi Akbar
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.
J Ophthalmic Vis Res. 2015 Jul-Sep;10(3):250-6. doi: 10.4103/2008-322X.170358.
To report the outcomes of cataract surgery at a large referral eye hospital and to identify factors associated with less than excellent visual outcomes.
Hospital records of patients, who had undergone age-related cataract extraction (1,285 procedures) within a two-year period were sampled randomly for 353 patients (405 eyes) and baseline characteristics were recorded. Up to three causes of visual loss (contributory reasons) were considered and the principal cause of "less than excellent outcome," i.e., best spectacle corrected visual acuity (BSCVA) <20/25 was defined as the primary reason.
Mean age of the participants was 68.6 years, and 50.7% of enrolled subjects were female. Phacoemulsification had been performed in 92.1% of cases. Out of 405 eyes, 54%, 78%, and 97% achieved BSCVA of ≥20/25, ≥20/40, and ≥20/200, respectively. Poor visual outcomes were significantly associated with older age (OR: 4.55 for age >70 years), female gender (OR: 4.64), ocular comorbidities (OR: 7.68), surgically challenging eyes (OR: 7.33), long and short eyes (versus eyes with normal axial length, OR: 3.24), and being operated on by a novice surgeon (OR: 2.41). The leading contributory reasons for unfavorable outcome, in descending order were maculopathy (17%), posterior capsule opacification (PCO, 11.8%), corneal opacity (5.7%), and degenerative myopia (5.4%).
Maculopathy, PCO, corneal opacity, degenerative myopia and ARMD may contribute to unfavorable outcomes in cataract surgery.
报告一家大型眼科转诊医院的白内障手术结果，并确定与视觉效果不佳相关的因素。
随机抽取两年内接受年龄相关性白内障摘除术（1285例手术）患者的医院记录，选取353例患者（405只眼），记录其基线特征。考虑多达三种视力丧失原因（促成因素），将“效果不佳”的主要原因定义为最佳矫正视力（BSCVA）<20/25的主要原因。
参与者的平均年龄为68.6岁，50.7%的受试者为女性。92.1%的病例采用了超声乳化术。在405只眼中，分别有54%、78%和97%的眼睛达到了BSCVA≥20/25、≥20/40和≥20/200。视觉效果不佳与高龄（70岁以上的患者，比值比：4.55）、女性（比值比：4.64）、眼部合并症（比值比：7.68）、手术难度大的眼睛（比值比：7.33）、眼轴长和短眼（与眼轴长度正常的眼睛相比，比值比：3.24）以及由新手外科医生进行手术（比值比：2.41）显著相关。导致不良结果的主要促成因素，按降序排列为黄斑病变（17%）、后囊膜混浊（PCO，11.8%）、角膜混浊（5.7%）和变性近视（5.4%）。
黄斑病变、PCO、角膜混浊、变性近视和年龄相关性黄斑变性可能导致白内障手术的不良结果。
