Neatrour Kristin, McAlpine Allison, Owens Timothy Brooks, Trivedi Rupal H, Poole Perry Lynn J
Storm Eye Institute, Medical University of South Carolina, 167 Ashley Avenue, Charleston, SC, 29425, USA.
J Ophthalmic Inflamm Infect. 2019 Feb 18;9(1):4. doi: 10.1186/s12348-019-0170-2.
The purpose of this study was to evaluate patients with persistent iritis after cataract surgery to determine its incidence and risk factors. Adjusting the management of patients at risk could allow for a more predictable post-operative course and outcome. A retrospective chart review was performed of patients who had post-operative iritis longer than 1 month after cataract surgery during a 2-year period at Storm Eye Institute at the Medical University of South Carolina (MUSC) in Charleston, South Carolina. Patient demographics and various pre-operative, intra-operative, and post-operative factors were analyzed for trends.
Thirty-nine patients (49 eyes) met the inclusion criteria, and this group was compared to a control cohort of 40 patients (66 eyes) who did not have persistent iritis after cataract surgery. The overall incidence of post-operative iritis was 1.75%. In all patients with post-operative iritis lasting greater than 1 month, African American race and pupil expansion device use were statistically significant factors. After excluding patients with a history of ocular inflammation or known inflammatory or autoimmune diagnosis (1.20% incidence), there were still a significantly higher proportion of African Americans compared to the control group. When patients with post-operative iritis of less than 6 months in duration were additionally excluded, the incidence was 0.32%, and history of diabetes was statistically significant in addition to race.
Risk factors for persistent iritis after cataract surgery include being diabetic, of African American racial background, and pupil expansion device use. These patients can be better informed of the higher risk of prolonged inflammation in their post-operative course, and peri-operative management can be tailored accordingly.
本研究旨在评估白内障手术后持续性虹膜炎患者，以确定其发病率及危险因素。调整对高危患者的管理可使术后病程和结果更具可预测性。对南卡罗来纳州查尔斯顿市南卡罗来纳医科大学（MUSC）风暴眼研究所2年内白内障手术后虹膜炎持续超过1个月的患者进行了回顾性病历审查。分析了患者人口统计学特征以及各种术前、术中和术后因素的趋势。
39例患者（49只眼）符合纳入标准，并将该组与40例白内障手术后无持续性虹膜炎的对照队列患者（66只眼）进行比较。术后虹膜炎的总体发病率为1.75%。在所有术后虹膜炎持续超过1个月的患者中，非裔美国人种族和使用瞳孔扩张器是具有统计学意义的因素。排除有眼部炎症病史或已知炎症或自身免疫性诊断的患者（发病率为1.20%）后，非裔美国人的比例仍显著高于对照组。当进一步排除术后虹膜炎持续时间少于6个月的患者时，发病率为0.32%，除种族外，糖尿病史也具有统计学意义。
白内障手术后持续性虹膜炎的危险因素包括糖尿病、非裔美国人种族背景和使用瞳孔扩张器。可让这些患者更好地了解其术后病程中炎症持续时间延长的较高风险，并据此调整围手术期管理。
