Department of Ophthalmology, Christian Medical College, CMC Schell Campus, Vellore, Tamil Nadu, India.
Indian J Ophthalmol. 2021 Mar;69(3):590-593. doi: 10.4103/ijo.IJO_1355_20.
We assessed the long-term impact of manual small incision cataract surgery (MSICS) in rural Central India using patient reported outcomes (PRO).
841 patients undergoing MSICS by a single surgeon from January 2012 to July 2013 were included. The same patients were contacted telephonically in November 2019 and were asked to report their perceived outcome of the cataract surgery. Data on the fellow eye status were also collected. These data were compared with objective data recorded at the time of surgery.
The mean age was 61.53 ± 10.9 with 59% women. 96% had presenting visual acuity (VA) ≤5/60. 86% had visually significant cataract in the fellow eye; 2.5% were cataract blind. 85% had unaided VA ≥ 6/18 at 6 weeks. 223 patients were contactable by telephone after 6 years. 55 had expired and their relatives gave the information. Of these, 90% reported "good" outcome. PRO at 6 years and unaided VA at 6 weeks after surgery correlated significantly (P = 0.05). 40% had undergone cataract surgery of the fellow eye in the interim. Of those who reported "not good" outcome, 70% had undergone fellow eye surgery, compared with 38% in those who reported "good" outcome (P = 0.005).
Telephonic PRO correlates with unaided VA 6 years after cataract surgery and could replace a follow-up visit. A PRO of poor vision in the already operated eye was the only factor correlating with fellow eye surgery.
我们使用患者报告的结果(PRO)评估印度中部农村地区手动小切口白内障手术(MSICS)的长期效果。
纳入了 2012 年 1 月至 2013 年 7 月间由同一位外科医生进行的 841 例 MSICS 患者。2019 年 11 月,我们通过电话联系了这些患者,并要求他们报告自己对白内障手术的感知结果。还收集了对侧眼情况的数据。将这些数据与手术时记录的客观数据进行了比较。
平均年龄为 61.53±10.9 岁,女性占 59%。96%的患者术前视力(VA)≤5/60。86%的患者对侧眼存在明显的白内障;2.5%的患者为白内障盲。85%的患者在术后 6 周时未矫正视力(UCVA)≥6/18。6 年后有 223 名患者可通过电话联系。55 人已经去世,他们的亲属提供了信息。其中,90%的人报告“良好”的结果。6 年时的 PRO 与术后 6 周时的 UCVA 显著相关(P=0.05)。在此期间,40%的患者对侧眼进行了白内障手术。报告“不好”结果的患者中,有 70%的人进行了对侧眼手术,而报告“好”结果的患者中,这一比例为 38%(P=0.005)。
电话 PRO 与白内障手术后 6 年的 UCVA 相关,可以替代随访。已经手术的眼睛视力不佳是与对侧眼手术相关的唯一因素。