Rosalind Franklin University of Medicine and Science/The Chicago Medical School, North Chicago, Illinois.
Glaucoma Associates of Texas, Dallas, Texas.
Ophthalmology. 2021 Sep;128(9):1292-1299. doi: 10.1016/j.ophtha.2021.02.012. Epub 2021 Feb 15.
Minimally invasive glaucoma surgery (MIGS) is increasingly performed at the time of cataract extraction. Understanding the demographic and clinical characteristics of patients undergoing MIGS procedures may provide insight into patient selection. This study evaluates racial-ethnic and other differences in the use of MIGS in persons with cataract and open-angle glaucoma (OAG).
Retrospective cohort study using Intelligent Research in Sight (IRIS) Registry data.
Patients aged ≥ 40 years with a diagnosis of OAG and no history of MIGS or cataract surgery who were undergoing cataract extraction, with or without MIGS, during 2013 to 2017 in the United States.
Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Variables assessed include age, sex, race-ethnicity, disease severity, insurance type, census region, comorbidity, and cup-to-disc ratio (CDR).
The odds of MIGS use was greater among patients who were aged ≥ 60 years (OR, 1.10 [95% CI, 1.05-1.16]); Black (OR, 1.11 [CI, 1.07-1.15]) compared with White; a Medicare recipient (OR, 1.12 [CI, 1.10-1.15]) versus privately insured; or in the Midwest (OR, 1.32 [CI, 1.28-1.36]) or Northeast (OR, 1.26 [CI, 1.22-1.30]) compared with the South. Having moderate rather than mild glaucoma (OR, 1.07 [CI, 1.04-1.11]) and a higher CDR (OR for 0.5 to 0.8 vs. <0.5, 1.24 [CI, 1.21-1.26]; OR for >0.8 to 1.0 vs. <0.5, 1.27 [CI, 1.23-1.32]) were also each associated with increased odds of MIGS use. Use of MIGS was less likely in women (OR, 0.96 [CI, 0.94-0.98]); patients taking 5 to 7 glaucoma medications (OR, 0.94 [CI, 0.90-0.99]) compared with 1 to 2 medications; and patients with severe, compared with mild, glaucoma (OR, 0.64 [CI, 0.61-0.67]).
This analysis highlights the importance of capturing race-ethnicity data and other pertinent patient characteristics in electronic health records to provide insight into practice patterns. Such data can be used to assess the long-term performance of MIGS and other procedures in various patient populations.
微创青光眼手术（MIGS）越来越多地在白内障摘除时进行。了解接受 MIGS 手术患者的人口统计学和临床特征，可能有助于了解患者选择。本研究评估了在患有白内障和开角型青光眼（OAG）的人群中，MIGS 在不同种族和民族中的使用情况和其他差异。
使用 Intelligent Research in Sight（IRIS）登记处数据的回顾性队列研究。
年龄≥40 岁，诊断为 OAG，且无 MIGS 或白内障手术史的患者，在美国，在 2013 年至 2017 年期间接受白内障摘除术，同时或不同时接受 MIGS。
使用多变量逻辑回归模型计算优势比（OR）和 95%置信区间（CI）。
评估的变量包括年龄、性别、种族-民族、疾病严重程度、保险类型、普查区、合并症和杯盘比（CDR）。
≥60 岁（OR，1.10[95%CI，1.05-1.16]）；黑人（OR，1.11[CI，1.07-1.15]）与白人相比；医疗保险（OR，1.12[CI，1.10-1.15]）而非私人保险；或中西部（OR，1.32[CI，1.28-1.36]）或东北部（OR，1.26[CI，1.22-1.30]）与南部相比，MIGS 使用的可能性更大。中度而非轻度青光眼（OR，1.07[CI，1.04-1.11]）和更高的 CDR（0.5 至 0.8 与<0.5 的比值，1.24[CI，1.21-1.26]；0.8 至 1.0 与<0.5 的比值，1.27[CI，1.23-1.32]）也与 MIGS 使用的可能性增加相关。女性（OR，0.96[CI，0.94-0.98]）；使用 5 至 7 种降眼压药物（OR，0.94[CI，0.90-0.99]）的患者与使用 1 至 2 种药物的患者相比；与轻度相比，严重青光眼（OR，0.64[CI，0.61-0.67]）患者的 MIGS 使用可能性较低。
本分析强调了在电子健康记录中捕获种族-民族数据和其他相关患者特征的重要性，以深入了解实践模式。此类数据可用于评估 MIGS 和其他手术在不同患者人群中的长期效果。
