University of Malaya, Faculty of Medicine, Department of Ophthalmology, University Malaya Eye Research Centre, Kuala Lumpur, Malaysia.
Selayang Hospital, Department of Ophthalmology, Selangor, Malaysia.
Med J Malaysia. 2021 Jan;76(1):35-40.
The aim of this study was to compare the postoperative refractive outcome after cataract surgery between a hospital-based and an outreach-based cataract service centre.
This study was conducted at the Hospital Selayang (HS), Selangor, Malaysia, a tertiary referral centre and an outreach-based cataract service centre (Pusat Pembedahan Katarak MAIWP, PPKM). Data was sourced from the Cataract Surgery Registry (CSR) in the National Eye Database (NED).
A total of 2318 surgeries were analysed. PPKM achieved postoperative refraction outcome within ±1.0D in 94.3% of cases compared with 88.4% in Selayang Hospital. Mean absolute prediction error was also better in PPKM (0.39±0.27D vs. 0.33±0.24D, p<0.001). Multivariate analysis showed that the tertiary hospital, persons of Chinese ethnicity, history of uveitis, previous history of ocular surgery and intraoperative complications as significant independent predictive factors for poor refractive outcomes.
The outreach-based cataract service centre, which incorporates streamlined process designs and workflows, achieved superior refractive outcomes within ±1 dioptre after cataract surgery compared to a tertiary hospital.
本研究旨在比较基于医院和外展服务中心的白内障手术术后屈光结果。
本研究在马来西亚雪兰莪州的塞拉央医院（HS）进行，该医院是一家三级转诊中心和外展服务白内障手术中心（MAIWP 白内障手术中心，PPKM）。数据来自国家眼科数据库（NED）中的白内障手术登记处（CSR）。
共分析了 2318 例手术。PPKM 术后屈光度在±1.0D 内的结果达到 94.3%，而塞拉央医院为 88.4%。PPKM 的平均绝对预测误差也更好（0.39±0.27D 与 0.33±0.24D，p<0.001）。多变量分析表明，三级医院、华族、葡萄膜炎史、眼部手术史和术中并发症是屈光结果不良的显著独立预测因素。
采用简化流程设计和工作流程的外展服务白内障手术中心，在白内障手术后屈光度在±1 以内达到了更好的屈光结果，优于三级医院。
