Department of Clinical Neuroscience, Division of Ophthalmology and Vision, Karolinska Institutet, St. Erik Eye Hospital, Stockholm, Sweden.
Department of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.
Acta Ophthalmol. 2018 Sep;96(6):592-599. doi: 10.1111/aos.13757. Epub 2018 Mar 25.
To study associations between intraoperative difficulties and changes in patient-perceived and postoperative visual function and visual satisfaction after cataract surgery.
Swedish multicenter, prospective, cross-sectional, nonrandomized, National Cataract Register study. A total of 10 979 patients (n = 10 979) who underwent cataract surgery from 2008 to 2011 completed the Catquest-9SF questionnaire before and 3 months postoperatively. Using Rasch analysis, we converted the nonparametric grading of the answers to parametric data and performed parametric statistical analyses. Multiple regression models were used to examine possible predictors associated with self-assessed visual function after cataract surgery.
Greater improvement in self-assessed visual function was seen in patients in whom trypan blue dye was used; those without a posterior capsular tear or an ocular comorbidity; and those who were younger, female and had low preoperative corrected distance visual acuity (CDVA) or high postoperative CDVA compared with their counterparts. Significantly higher self-assessed postoperative visual function was seen in patients in whom trypan blue dye was used and those with no posterior capsular tear or ocular comorbidity and no use of capsular hooks; and those who were younger and had low preoperative or high postoperative CDVA compared with their counterparts. The risk of general dissatisfaction after cataract surgery was significantly greater in patients with a posterior capsule tear, ocular comorbidity or low postoperative CDVA, and those in whom mechanical pupillary stretching was performed.
Several intraoperative difficulties, posterior capsular tear, ocular comorbidity, age, gender, and preoperative and postoperative CDVAs affect patient improvement and self-assessed visual function after cataract surgery.
研究白内障手术后术中困难与患者感知的和术后视觉功能及视觉满意度变化之间的关系。
这是一项瑞典多中心、前瞻性、横断面、非随机、全国性白内障登记研究。2008 年至 2011 年期间，共有 10979 例（n=10979）患者接受白内障手术，这些患者在术前和术后 3 个月完成了 Catquest-9SF 问卷。我们使用 Rasch 分析将答案的非参数分级转换为参数数据，并进行参数统计分析。使用多元回归模型来检验与白内障手术后自我评估视觉功能相关的可能预测因素。
与对照组相比，使用曲安奈德染料、无后囊膜破裂或眼部合并症、年龄较小、女性、术前矫正远视力（CDVA）较低或术后 CDVA 较高的患者自我评估视觉功能改善更大。与对照组相比，使用曲安奈德染料、无后囊膜破裂或眼部合并症、无使用囊袋钩的患者，以及年龄较小、术前或术后 CDVA 较低的患者，自我评估术后视觉功能更高。与对照组相比，后囊膜破裂、眼部合并症、术后 CDVA 较低或行机械性瞳孔扩张的患者，白内障手术后总体不满意的风险显著增加。
一些术中困难，如后囊膜破裂、眼部合并症、年龄、性别以及术前和术后 CDVA，会影响白内障手术后患者的改善和自我评估的视觉功能。
