Gadzhanova Svetla, Gillam Marianne, Roughead Elizabeth
Quality Use of Medicines and Pharmacy Research Centre, University of South Australia, Adelaide, SA, Australia.
Acta Ophthalmol. 2020 Jun;98(4):e495-e498. doi: 10.1111/aos.14286. Epub 2019 Oct 25.
To investigate the impact of the type of the intraocular lenses (IOLs) in first-eye cataract surgery in elderly people on the risk of hospitalisation due to falls and injuries.
A retrospective cohort study was conducted using the Australian Government Department Veterans' Affairs claims data. All people aged 65 years and above who had first cataract surgery between January 2007 and July 2017 were identified. Two cohorts were established depending on the type of IOL-monofocal and multifocal. The risk of injuries and falls requiring hospitalisation in the first 3 months post the surgery was assessed using Cox proportional hazard models with age at entry as primary time scale and adjusting for gender, comorbidities and prior history of falls.
There were 45 728 people across the two cohorts with the majority receiving monofocal lenses (97%), followed by multifocal lenses (3%) at the time of first cataract surgery. The risk of injury and falls was lower (but not significant) in the multifocal cohort compared to monofocal cohort (adjusted hazard ratio (aHR) 0.56, 95% CI 0.26-1.17). The risk was also lower (but not significant) when stratifying by age group at the time of the surgery.
Regardless of age, multifocal lenses did not appear to be associated with the higher risk of serious injuries and falls after first-eye cataract surgery compared to monofocal lenses.
探讨老年人第一眼白内障手术中人工晶状体（IOL）类型对因跌倒和受伤而住院风险的影响。
使用澳大利亚政府退伍军人事务部的索赔数据进行一项回顾性队列研究。确定了2007年1月至2017年7月期间接受第一眼白内障手术的所有65岁及以上的人群。根据IOL类型（单焦点和多焦点）建立了两个队列。使用Cox比例风险模型，以入院时的年龄作为主要时间尺度，并对性别、合并症和既往跌倒史进行调整，评估手术后前3个月内需要住院治疗的受伤和跌倒风险。
两个队列共有45728人，在第一眼白内障手术时，大多数人接受单焦点晶状体（97%），其次是多焦点晶状体（3%）。与单焦点队列相比，多焦点队列中受伤和跌倒的风险较低（但不显著）（调整后的风险比（aHR）为0.56，95%置信区间为0.26-1.17）。按手术时的年龄组分层时，风险也较低（但不显著）。
与单焦点晶状体相比，无论年龄大小，第一眼白内障手术后多焦点晶状体似乎与严重受伤和跌倒的较高风险无关。
