From the School of Medicine (Patel, Clarke, Kim, Murri), Baylor College of Medicine and the Cullen Eye Institute (Ali, Weng, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, and the Department of Biostatistics (Tuft), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
From the School of Medicine (Patel, Clarke, Kim, Murri), Baylor College of Medicine and the Cullen Eye Institute (Ali, Weng, Al-Mohtaseb), Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, and the Department of Biostatistics (Tuft), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Cataract Refract Surg. 2018 Jul;44(7):856-863. doi: 10.1016/j.jcrs.2018.05.006. Epub 2018 Jun 14.
To determine the risk factors, intraoperative and postoperative complications, therapeutic interventions, and visual outcomes for persistent postoperative inflammation in primary resident-performed cataract surgeries.
Ben Taub General Hospital, Houston, Texas, USA.
Retrospective case series.
Primary resident-performed cataract surgeries from January 2012 to June 2015 were analyzed for persistent postoperative inflammation, defined as persistent anterior chamber inflammatory reaction after a standard 1-month topical corticosteroid and nonsteroidal antiinflammatory drug (NSAID) drops taper. Preoperative characteristics, operative complications, therapeutic modalities, and duration of therapy were analyzed. The primary outcome measures were duration of corticosteroid and NSAID therapy, treatment modalities, and postoperative visual outcomes at the 1-month postoperative visit.
The study assessed 1290 primary resident-performed cataract surgeries. Persistent postoperative inflammation occurred in 82 eyes (6.6%). The presumed etiology was classified as idiopathic persistent postoperative inflammation, nonadherence to topical therapy, and complicated cataract surgery. Patients with persistent postoperative inflammation were more likely of African American descent, had hypertension, or used aspirin, anticoagulants, or prostaglandins (P = .019, P = .027, P = .028, P = .020, respectively). The complicated cataract subgroup required a longer duration of therapy (P = .021) and was the only subgroup to require injections or systemic corticosteroids. There was no significant difference in postoperative corrected distance visual acuity (CDVA) when comparing patients with persistent postoperative inflammation with those without inflammation or between the subgroups.
The idiopathic and nonadherent subgroups were successfully treated with topical antiinflammatory therapy; the complicated subgroup required longer duration and multiple modalities of treatment. Visual outcomes were comparable to the general cataract population with no differences in postoperative CDVA.
确定原发性住院医生施行的白内障手术后持续性术后炎症的危险因素、术中及术后并发症、治疗干预措施和视力结果。
美国德克萨斯州休斯顿本陶布综合医院。
回顾性病例系列。
分析 2012 年 1 月至 2015 年 6 月期间原发性住院医生施行的白内障手术，以确定持续性术后炎症，其定义为标准 1 个月局部皮质类固醇和非甾体抗炎药（NSAID）滴剂停药后仍存在持续性前房炎症反应。分析术前特征、手术并发症、治疗方法以及 1 个月术后随访时的治疗持续时间。主要观察指标是皮质类固醇和 NSAID 治疗的持续时间、治疗方法和术后 1 个月时的视力结果。
该研究评估了 1290 例原发性住院医生施行的白内障手术。82 只眼（6.6%）发生持续性术后炎症。推测病因分为特发性持续性术后炎症、局部治疗不依从和复杂白内障手术。持续性术后炎症患者更可能为非裔美国人、患有高血压，或使用阿司匹林、抗凝剂或前列腺素（P =.019、P =.027、P =.028、P =.020，分别）。复杂白内障亚组需要更长的治疗时间（P =.021），也是唯一需要注射或全身皮质类固醇的亚组。比较有持续性术后炎症的患者与无炎症的患者或比较各亚组之间，术后矫正视力（CDVA）无显著差异。
特发性和不依从性亚组通过局部抗炎治疗成功治疗；复杂亚组需要更长的治疗时间和多种治疗方法。视力结果与一般白内障患者相当，术后 CDVA 无差异。
