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不同种族和糖尿病患者群体白内障手术效果的基准评估:术后最终视力及术后黄斑囊样水肿发生率

Benchmarking cataract surgery outcomes in an ethnically diverse and diabetic population: final post-operative visual acuity and rates of post-operative cystoid macular oedema.

作者信息

Oyewole K, Tsogkas F, Westcott M, Patra S

机构信息

Ophthalmology Department, Whipps Cross University hospital, Leytonstone, London, UK.

Ophthalmology Department, Whipps Cross University Hospital, London, UK.

出版信息

Eye (Lond). 2017 Dec;31(12):1672-1677. doi: 10.1038/eye.2017.96. Epub 2017 Jun 23.

Abstract

PurposeTo determine visual acuity and rates of post-operative cystoid macular oedema (CMO) in an ethnically diverse and predominantly diabetic population.MethodsThe study was undertaken over a one year period. Snellen visual acuity (VA) was measured pre and 4-8 weeks post-operatively and optical coherence topography (OCT) was performed at baseline and post-operatively. No eyes received prophylactic non-steroidal anti-inflammatory drugs (NSAIDs) prior to or after surgery.ResultsOut of 262 eyes, 59% were in the Black, Asian and minority ethnic group (BAME), 57% had a history of diabetes mellitus and 34% had pre-existing diabetic retinopathy. 76% of all eyes achieved 6/12 post-operative VA at the first postoperative review and the incidence of post-operative CMO within the study population was 7.6%. In patients with a history of diabetes mellitus the incidence of post-operative CMO was 10.7% compared to 3.5% in those without diabetes. This was found to be clinically significant (P=0.0297).ConclusionWe believe this is the first study to benchmark standards for care in this demographic of patients. A history of diabetes mellitus, irrespective of whether there is diabetic retinopathy or not, is an independent risk factor for the development of post-operative CMO in patients undergoing cataract surgery (P=0.0297). Ethnicity is not an independent risk factor for the development of post-operative CMO.

摘要

目的

确定一个种族多样且主要为糖尿病患者群体的视力及术后黄斑囊样水肿(CMO)发生率。

方法

该研究为期一年。术前及术后4 - 8周测量Snellen视力(VA),并在基线及术后进行光学相干断层扫描(OCT)。所有眼睛在手术前后均未接受预防性非甾体抗炎药(NSAIDs)治疗。

结果

在262只眼中,59%属于黑种人、亚洲人和少数族裔群体(BAME),57%有糖尿病病史,34%有糖尿病视网膜病变病史。在首次术后复查时,76%的眼睛术后视力达到6/12,研究人群中术后CMO的发生率为7.6%。有糖尿病病史的患者术后CMO发生率为10.7%,无糖尿病患者为3.5%。这在临床上具有显著意义(P = 0.0297)。

结论

我们认为这是第一项为该患者群体的护理标准设定基准的研究。糖尿病病史,无论是否存在糖尿病视网膜病变,都是白内障手术患者发生术后CMO的独立危险因素(P = 0.0297)。种族不是术后CMO发生的独立危险因素。

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