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白内障手术与多民族亚洲队列中老年相关性黄斑变性的 6 年发病率。

Cataract Surgery and the 6-year Incidence of Age-Related Macular Degeneration in a Multiethnic Asian Cohort.

机构信息

Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.

Duke-NUS Medical School, Singapore.

出版信息

Asia Pac J Ophthalmol (Phila). 2020 Mar-Apr;9(2):130-136. doi: 10.1097/APO.0000000000000275.

Abstract

PURPOSE

The aim of this study was to determine whether cataract surgery was associated with age-related macular degeneration (AMD) development in Asian patients.

DESIGN

Longitudinal cohort study.

METHODS

Participants from the Singapore Malay and Indian Eye Studies were recruited between 2004 and 2015. A total of 6790 late-AMD-free eyes from 3475 individuals were followed for 6 years on average. Multivariable regression analysis using generalized estimating equations determined associations between cataract surgery and the incidence of any, early, and late AMD.

RESULTS

The mean age (SD) of participants was 55.5 (9.1) years; 48.1% were male; 11.3% of eyes had cataract surgery recorded; incident any, early, and late AMD developed in 238 (3.6%), 222 (3.4%), and 29 (0.4%) eyes, respectively. Operated eyes had higher incidence of late AMD [1.4% vs 0.3%; adjusted risk ratio (RR): 3.47, 95% confidence interval (CI) 1.40-8.57], but not early AMD (6.0% vs 3.0%, adjusted RR: 1.12, 95% CI 0.76-1.64) or any AMD (6.9 vs 3.2%, adjusted RR: 1.23, 95% CI 0.85-1.78).

CONCLUSIONS

Our data are consistent with findings in population-based Caucasian studies that cataract surgery may be associated with incidence of late AMD. However, the absolute risk of late AMD development remains low and physicians should continue to balance the benefits and risks of cataract surgery in elderly patients.

摘要

目的

本研究旨在确定白内障手术是否与亚洲患者的年龄相关性黄斑变性(AMD)发展有关。

设计

纵向队列研究。

方法

本研究于 2004 年至 2015 年期间招募了来自新加坡马来族和印度裔眼部研究的参与者。共有 3475 名参与者的 6790 只无晚期 AMD 眼平均随访 6 年。使用广义估计方程的多变量回归分析确定了白内障手术与任何、早期和晚期 AMD 发生率之间的关联。

结果

参与者的平均年龄(SD)为 55.5(9.1)岁;48.1%为男性;11.3%的眼记录有白内障手术;分别有 238 只(3.6%)、222 只(3.4%)和 29 只(0.4%)眼发生任何、早期和晚期 AMD。手术眼晚期 AMD 的发生率较高[1.4%比 0.3%;调整后的风险比(RR):3.47,95%置信区间(CI)1.40-8.57],但早期 AMD(6.0%比 3.0%,调整 RR:1.12,95% CI 0.76-1.64)或任何 AMD(6.9%比 3.2%,调整 RR:1.23,95% CI 0.85-1.78)发生率并无差异。

结论

我们的数据与基于人群的白种人研究结果一致,即白内障手术可能与晚期 AMD 的发生有关。然而,晚期 AMD 发展的绝对风险仍然较低,医生应继续权衡白内障手术对老年患者的利弊。

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