美国退伍军人事务部的白内障手术实践。

Cataract surgery practices in the United States Veterans Health Administration.

机构信息

From the Program in Liberal Medical Education (Havnaer), Brown University, the Division of Ophthalmology (Havnaer, Greenberg), the Warren Alpert Medical School, Brown University, and the Section of Ophthalmology (Havnaer, Greenberg), Providence Veterans Administration Medical Center, Providence, Rhode Island, the Section of Ophthalmology (Cockerham), Palo Alto Veterans Administration Medical Center and the Departments of Ophthalmology and Pathology (Cockerham), Stanford University School of Medicine, Palo Alto, California, the Department of Quantitative Health Sciences (Clark), University of Massachusetts Medical School, Worcester, Massachusetts, and the Section of Ophthalmology, Veterans Administration Tennessee Valley Healthcare System and Vanderbilt Eye Institute (Chomsky), Nashville, Tennessee, USA.

出版信息

J Cataract Refract Surg. 2017 Apr;43(4):543-551. doi: 10.1016/j.jcrs.2017.01.016.

DOI:10.1016/j.jcrs.2017.01.016

PMID:28532941

Abstract

PURPOSE

To describe current cataract surgery practices within the United States Veterans Health Administration (VHA).

SETTING

Veterans Health Administration hospitals in the U.S.

DESIGN

Retrospective data analysis.

METHODS

An initial e-mail containing a link to an anonymous 32-question survey of cataract surgery practices was sent to participants in May 2016. Two reminder e-mails were sent to nonresponders 1 week and 2 weeks after the initial survey was sent; the remaining nonresponders were called twice over a 2-week period. The data were analyzed using descriptive statistics.

RESULTS

The response rate was 75% (67/89). Cataract surgeons routinely ordered preoperative testing in 29 (45%) of 65 sections and preoperative consultations in 26 (39%) of 66 sections. In 22 (33%) of 66 sections, cataract surgeons administered intracameral antibiotics. In 61 (92%) of 66 sections, cataract surgeons used toric intraocular lenses (IOLs). In 20 (30%) of 66 sections, cataract surgeons used multifocal IOLs. Cataract surgeons in 6 (9%) of 66 sections performed femtosecond laser-assisted cataract surgery. In 6 (9%) of 66 sections, cataract surgeons performed immediate sequential bilateral cataract surgery. Forty-nine (74%) ophthalmology chiefs reported a high level of satisfaction with Veterans Affairs ophthalmology.

CONCLUSIONS

The survey results indicate that in cataract surgery in the VHA, routine preoperative testing is commonly performed and emerging practices, such as femtosecond laser-assisted cataract surgery and immediate sequential bilateral cataract surgery, have limited roles. The results of this survey could benchmark future trends in U.S. cataract surgery practices, especially in teaching hospital settings.

摘要

目的

描述美国退伍军人事务部（VHA）内目前的白内障手术实践。

背景

美国退伍军人事务部医院。

设计

回顾性数据分析。

方法

2016 年 5 月，向参与者发送了一封包含白内障手术实践情况的匿名 32 个问题调查链接的初始电子邮件。在初始调查发送后 1 周和 2 周，向未回复者发送了 2 封提醒电子邮件；其余未回复者在两周内被呼叫了两次。使用描述性统计数据对数据进行分析。

结果

回复率为 75%（67/89）。白内障外科医生在 65 个部分中的 29 个（45%）常规要求进行术前检查，在 66 个部分中的 26 个（39%）要求进行术前咨询。在 22 个部分（33%）中，白内障外科医生给予了眼内抗生素。在 61 个部分（92%）中，白内障外科医生使用了散光人工晶状体（IOL）。在 20 个部分（30%）中，白内障外科医生使用了多焦点 IOL。在 66 个部分中的 6 个（9%）中，白内障外科医生进行了飞秒激光辅助白内障手术。在 6 个部分（9%）中，白内障外科医生进行了即刻序贯双侧白内障手术。49 名（74%）眼科主任报告对退伍军人事务部眼科的满意度很高。