Kim Soo Han, Yu Min Heui, Lee Joung Hyuck, Kim Sun Woong, Rah Sang Hoon
Department of Ophthalmology, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea.
Yonsei Med J. 2019 May;60(5):467-473. doi: 10.3349/ymj.2019.60.5.467.
To assess the nationwide rate of acute postoperative endophthalmitis (APE) after cataract extraction in Korea and to evaluate potential risk factors thereof.
Nationwide insurance claims data from July 2014 to June 2017 were reviewed. All patients with phacoemulsification or extracapsular/intracapsular cataract extraction were included. Exclusion criteria were combined glaucoma surgery or total vitrectomy or when the patient had a history of intraocular foreign body.
In total, 1505103 cases (982203 patients) were included. APE developed in 953 cases (938 patients) with an overall incidence of 0.063%. After adjusting for possible confounding factors, male sex [odds ratio (OR) 1.42; 95% confidence interval (CI) 1.25-1.61; <0.001], primary clinical setting, operations performed in non-major cities, usage of sutures (OR 2.82; 95% CI 2.13-3.74; <0.001), anterior vitrectomy (OR 8.71; 95% CI 6.71-11.32; <0.001), aphakic cataract surgery (OR 1.52; 95% CI 1.03-2.22; =0.033), hypertension (OR 1.40; 95% CI 1.18-1.66; <0.001), diabetes (OR 1.59; 95% CI 1.31-1.93; <0.001), and chronic renal failure (OR 1.28; 95% CI 1.01-1.62; =0.039) were found to be related to APE development.
The incidence of APE after cataract extraction was consistent with reports from other studies. Additional research is needed to determine the relationship of newly found risk factors, such as hypertension, primary clinical setting, chronic renal failure, and usage of suturing, with APE development.
评估韩国白内障摘除术后急性术后眼内炎（APE）的全国发病率，并评估其潜在危险因素。
回顾了2014年7月至2017年6月的全国保险理赔数据。纳入所有接受超声乳化或囊外/囊内白内障摘除术的患者。排除标准为合并青光眼手术或全玻璃体切除术，或患者有眼内异物史。
共纳入1505103例（982203名患者）。953例（938名患者）发生了APE，总发病率为0.063%。在对可能的混杂因素进行调整后，发现男性[比值比（OR）1.42；95%置信区间（CI）1.25 - 1.61；<0.001]、基层临床机构、在非大城市进行的手术、缝线的使用（OR 2.82；95% CI 2.13 - 3.74；<0.001）、前部玻璃体切除术（OR 8.71；95% CI 6.71 - 11.32；<0.001）、无晶状体白内障手术（OR 1.52；95% CI 1.03 - 2.22；=0.033）、高血压（OR 1.40；95% CI 1.18 - 1.66；<0.001）、糖尿病（OR 1.59；95% CI 1.31 - 1.93；<0.001）和慢性肾衰竭（OR 1.28；95% CI 1.01 - 1.62；=0.039）与APE的发生有关。
白内障摘除术后APE的发病率与其他研究报告一致。需要进一步研究以确定新发现的危险因素，如高血压、基层临床机构、慢性肾衰竭和缝线使用与APE发生之间的关系。
