Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA; Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
Am J Ophthalmol. 2021 Feb;222:157-165. doi: 10.1016/j.ajo.2020.08.020. Epub 2020 Aug 18.
To determine if there is an increased incidence rate of post-cataract surgery (pcs) anterior ischemic optic neuropathy (AION) compared to spontaneous AION (sAION).
Retrospective, population-based cohort.
Patients diagnosed with AION from January 1, 1990, through December 31, 2016, while residing in Olmsted County, Minnesota. Patients with cataract surgery preceding AION were included in the pcsAION cohort defined in 2 ways: AION within 2 months and AION within 1 year of cataract surgery. The incidence rates of pcsAION and sAION were compared using Poisson regression models.
During the study period, 102 residents developed AION. The median age was 65 years (range, 40-90 years), 44 (43.1%) were female. Twenty of 102 (19.6%) patients had previous cataract surgery, of which 2 and 9 developed AION within 2 months and 1 year of surgery, respectively. The annual incidence rate of pcsAION within 2 months of surgery (8.6 per 100,000) was not significantly greater than the annual incidence rate of sAION (6.9 per 100,000; P = .78). However, the annual incidence rate of pcsAION within 1 year of surgery (38.9 per 100,000) was significantly higher than the incidence rate of sAION (6.5 per 100,000; P < .001).
The incidence of AION is increased in the first year after cataract surgery, but not in the early (i.e., 2 months) postoperative period.
确定白内障手术后（pcs）前部缺血性视神经病变（AION）的发生率是否高于自发性 AION（sAION）。
回顾性、基于人群的队列研究。
1990 年 1 月 1 日至 2016 年 12 月 31 日期间，在明尼苏达州奥姆斯特德县居住的患者被诊断为 AION。将白内障手术前发生 AION 的患者纳入 pcsAION 队列，该队列有两种定义方式：白内障手术后 2 个月内和白内障手术后 1 年内发生 AION。采用泊松回归模型比较 pcsAION 和 sAION 的发生率。
研究期间，有 102 名居民发生了 AION。中位年龄为 65 岁（范围，40-90 岁），44 名（43.1%）为女性。102 名患者中有 20 名（19.6%）曾接受过白内障手术，其中 2 名和 9 名分别在手术后 2 个月和 1 年内发生了 AION。术后 2 个月内 pcsAION 的年发生率（8.6/10 万）与 sAION 的年发生率（6.9/10 万）无显著差异（P=.78）。然而，术后 1 年内 pcsAION 的年发生率（38.9/10 万）显著高于 sAION 的年发生率（6.5/10 万；P <.001）。
白内障手术后第一年 AION 的发生率增加，但在早期（即术后 2 个月内）没有增加。
