University of California, San Francisco, San Francisco, California.
Colorado Permanente Medical Group, Lafayette, Colorado.
Ophthalmology. 2016 Apr;123(4):723-8. doi: 10.1016/j.ophtha.2015.12.020. Epub 2016 Jan 22.
To identify safety and effectiveness outcomes of office-based cataract surgery. Each year, approximately 3.7 million cataract surgeries in the United States are performed in Ambulatory Surgery Center (ASC) and Hospital Outpatient Department (HOPD) locations. Medicare in July 2015 published a solicitation for expert opinion on reimbursing office-based cataract surgery.
Large-scale, retrospective, consecutive case series of cataract surgeries performed in Minor Procedure Rooms (MPRs) of a large US integrated healthcare center.
More than 13 500 patients undergoing elective office-based cataract surgery.
Phacoemulsification cataract surgery performed in MPRs of Kaiser Permanente Colorado from 2011 to 2014.
Postoperative visual acuity and intraoperative and postoperative adverse events (AEs).
Office-based cataract surgery was completed in 21 501 eyes (13 507 patients, age 72.6±9.6 years). Phacoemulsification was performed in 99.9% of cases, and manual extracapsular extraction was performed in 0.1% of cases. Systemic comorbidities included hypertension (53.5%), diabetes (22.3%), and chronic obstructive pulmonary disease (9.4%). Postoperative mean best-corrected visual acuity measured 0.14±0.26 logarithm of the minimum angle of resolution units. Intraoperative ocular AEs included 119 (0.55%) cases of capsular tear and 73 (0.34%) cases of vitreous loss. Postoperative AEs included iritis (n = 330, 1.53%), corneal edema (n = 110, 0.53%), and retinal tear or detachment (n = 30, 0.14%). No endophthalmitis was reported. Second surgeries were performed in 0.70% of treated eyes within 6 months. There were no life- or vision-threatening intraoperative or perioperative AEs.
This is the largest US study to investigate the safety and effectiveness of office-based cataract surgery performed in MPRs. Office-based efficacy outcomes were consistently excellent, with a safety profile expected of minimally invasive cataract procedures performed in ASCs and HOPDs.
确定门诊白内障手术的安全性和有效性结果。每年，美国约有 370 万例白内障手术在门诊手术中心（ASC）和医院门诊部门（HOPD）进行。2015 年 7 月，医疗保险发布了一项关于支付门诊白内障手术费用的征求意见稿，征求专家意见。
在美国一家大型综合医疗中心的小型手术室（MPR）进行的白内障手术的大规模、回顾性、连续病例系列研究。
超过 13500 名接受选择性门诊白内障手术的患者。
2011 年至 2014 年，在科罗拉多州 Kaiser Permanente 的 MPR 进行超声乳化白内障手术。
术后视力和术中及术后不良事件（AE）。
完成了 21501 只眼（13507 例患者，年龄 72.6±9.6 岁）的门诊白内障手术。99.9%的病例行超声乳化白内障吸除术，0.1%的病例行手法白内障囊外摘除术。全身合并症包括高血压（53.5%）、糖尿病（22.3%）和慢性阻塞性肺疾病（9.4%）。术后平均最佳矫正视力为 0.14±0.26 对数最小角分辨率单位。术中眼部 AE 包括 119 例（0.55%）囊膜撕裂和 73 例（0.34%）玻璃体丢失。术后 AE 包括虹膜炎（n=330，1.53%）、角膜水肿（n=110，0.53%）和视网膜裂孔或脱离（n=30，0.14%）。无眼内炎报告。6 个月内有 0.70%的治疗眼行二次手术。术中或围手术期无危及生命或视力的 AE。
这是美国最大的研究，旨在调查 MPR 中进行的门诊白内障手术的安全性和有效性。门诊疗效结果始终出色，安全性与 ASC 和 HOPD 中进行的微创白内障手术相当。
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