From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA..
From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Am J Ophthalmol. 2021 Jul;227:201-210. doi: 10.1016/j.ajo.2021.02.018. Epub 2021 Feb 21.
To characterize and compare patient-reported recovery of function after cataract or glaucoma surgery using a novel visual analog scale.
Prospective observational cohort study.
Daily for 2 weeks and weekly thereafter, patients recovering from trabeculectomy, tube shunt implantation, or cataract extraction (CE) completed a diary-style questionnaire including visual analog scales (VASs; scored 0-100) grading pain and global function. Clinical examination data and medical histories were collected. Generalized estimating equation models evaluated associations between VAS function scores and pain or visual acuity (VA) and compared scores between surgery types.
Among 51 participants followed for 12 weeks, tube shunt placement reduced postoperative day 1 (POD1) function by 47 of 100 points vs CE (P = .006), while trabeculectomy did not reduce POD1 function vs CE (P = .33). After CE, trabeculectomy, and tube shunt placement, average VAS function scores increased 13.94 per week for 2 weeks (P < .001), 4.18 per week for 4 weeks (P = .02), and 7.76 per week for 7 weeks (P < .001), respectively. After those timepoints, there was no further significant change. Beyond 2 weeks, pain levels plateaued, and VA returned to baseline across surgery types; function was inversely related to pain or VA only for the first 2 or 4 weeks, respectively.
Patients recovering from cataract and glaucoma surgery report reduced function in the postoperative period. Tube shunt implantation causes greater morbidity than trabeculectomy, and both are associated with slower improvement than CE. Early postoperative function is associated with VA and pain, but neither fully explains reported impairment. A VAS for function may efficiently capture postoperative recovery.
使用新型视觉模拟评分法对白内障或青光眼手术后的患者功能恢复进行特征描述和比较。
前瞻性观察队列研究。
行小梁切除术、引流管植入术或白内障摘除术(CE)的患者在术后 2 周内每天、之后每周完成一份日记式问卷,问卷包括视觉模拟评分(VAS;评分 0-100)评估疼痛和整体功能。收集临床检查数据和病史。广义估计方程模型评估 VAS 功能评分与疼痛或视力(VA)之间的相关性,并比较手术类型之间的评分。
在随访 12 周的 51 名参与者中,与 CE 相比,引流管放置术在术后第 1 天(POD1)降低了 47 分(P=0.006),而小梁切除术并未降低 POD1 功能(P=0.33)。在 CE、小梁切除术和引流管放置术后,VAS 功能评分平均每周增加 13.94 分(持续 2 周,P<0.001)、每周增加 4.18 分(持续 4 周,P=0.02)和每周增加 7.76 分(持续 7 周,P<0.001)。在这些时间点之后,没有进一步的显著变化。超过 2 周后,疼痛水平趋于平稳,VA 在所有手术类型中均恢复至基线;功能仅在前 2 或 4 周与疼痛或 VA 呈负相关。
白内障和青光眼手术后的患者报告术后功能下降。引流管植入术比小梁切除术引起更大的发病率,且改善速度均比 CE 慢。术后早期功能与 VA 和疼痛相关,但均不能完全解释报告的损害。功能 VAS 可能高效地捕捉术后恢复情况。