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医疗保险覆盖年龄患者的斜视手术:十多年的见解

Strabismus surgery for Medicare-aged patients: more than a decade of insights.

作者信息

Fang Sophia Y, Gandhi Nandini, Satterfield Denise, O'Hara Mary

机构信息

Department of Ophthalmology, University of California, Davis, School of Medicine.

Department of Ophthalmology, University of California, Davis, School of Medicine.

出版信息

J AAPOS. 2018 Jun;22(3):170-173.e1. doi: 10.1016/j.jaapos.2017.12.017. Epub 2018 Apr 12.

Abstract

BACKGROUND

The psychosocial and functional impact of strabismus among the elderly is increasingly important as life expectancy increases and factors that enhance the quality of life become more significant. The purpose of this study was to characterize the demographics, presenting complaints, health status, underlying etiology, and outcomes of strabismus surgery in three age cohorts of Medicare-aged patients.

METHODS

The medical records of patients at least 65 years of age who underwent strabismus surgery between 2004 and 2015 in a university-based strabismus practice were reviewed retrospectively.

RESULTS

A total of 110 patients were identified and divided into three age cohorts for analysis: young-old (age 65-74), middle-old (age 75-84), and old-old (age 85+). At least 75% of patients in all cohorts cited diplopia as their chief complaint (P = 0.87). There was no difference in sex distribution, type of deviation, underlying etiology, or preoperative American Society of Anesthesiologists physical status classification scores between the cohorts (P = 0.68, P = 0.53, P = 0.71, P = 0.93, resp.). By the 6- to 8-week postoperative visit, 63% of all patients reported complete resolution of their presenting chief complaint, 23% reported some improvement, and 11% reported no improvement, with no difference between the cohorts (P = 0.12).

CONCLUSIONS

Given the functional and psychosocial impact of strabismus in the elderly, this study lends support to consideration of surgery as a viable option to successfully treat strabismus among the oldest age cohorts.

摘要

背景

随着预期寿命的增加以及提高生活质量的因素变得更加重要,斜视对老年人的心理社会和功能影响日益显著。本研究的目的是描述医疗保险年龄患者三个年龄组中斜视手术的人口统计学特征、主要诉求、健康状况、潜在病因及手术结果。

方法

回顾性分析2004年至2015年在一所大学斜视诊所接受斜视手术的至少65岁患者的病历。

结果

共确定110例患者并分为三个年龄组进行分析:年轻老年人(65 - 74岁)、中年老年人(75 - 84岁)和老年老年人(85岁及以上)。所有年龄组中至少75%的患者称复视为主要诉求(P = 0.87)。各年龄组之间在性别分布、斜视类型、潜在病因或术前美国麻醉医师协会身体状况分类评分方面无差异(分别为P = 0.68、P = 0.53、P = 0.71、P = 0.93)。术后6至8周复诊时,所有患者中有63%报告其主要诉求完全缓解,23%报告有一定改善,11%报告无改善,各年龄组之间无差异(P = 0.12)。

结论

鉴于斜视对老年人的功能和心理社会影响,本研究支持将手术作为在最高龄年龄组中成功治疗斜视的可行选择。

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