Dept of Clinical Sciences Lund, Ophthalmology, Lund University, Skåne University Hospital, Lund, Sweden
Br J Ophthalmol. 2022 Oct;106(10):1373-1379. doi: 10.1136/bjophthalmol-2020-318645. Epub 2021 Apr 22.
BACKGROUND/AIMS: The aim of this study was to develop a risk model for intraoperative complication (IC) during cataract surgery, defined as posterior capsule rupture and/or zonular dehiscence, and to include previous intravitreal therapy (pIVT) in the model.
This retrospective register-based study covered patients reported to the Swedish National Cataract Register (SNCR) between 1 January 2010 and 30 June 2018. Odds ratios (ORs) were used to quantify association strength of each variable with IC. Data from the SNCR were cross referenced with the Swedish Macula Register to include data on pIVT. Variables statistically significant in the univariate analyses (p<0.05) were included in a multivariate logistic regression model.
The inclusion criteria were met by 907 499 eyes. The overall rate of IC was 0.86%. Variables significantly associated with IC were best corrected visual acuity ≥1.0 LogMAR (OR (adjusted): 1.75, p<0.001), age ≥90 years (OR: 1.25, p<0.001), male sex (OR: 1.09, p<0.01), pseudoexfoliation (OR: 1.33, p<0.001), glaucoma (OR: 1.11, p<0.05), diabetic retinopathy (OR: 1.35, p<0.001), pIVT (OR: 1.45, p<0.05), surgeon's experience <600 surgeries (OR: 2.77, p<0.001), use of rhexis hooks (OR: 6.14, p<0.001), blue staining (OR: 1.87, p<0.001) and mechanical pupil dilation (OR: 1.52, p<0.001).
The risk model can be used in the preoperative setting to predict the probability of IC, to facilitate planning of surgery and improving patient communication. Patients who have undergone intravitreal therapy prior to cataract surgery have an increased risk of IC during cataract surgery.
背景/目的：本研究旨在开发一种白内障手术中术中并发症（IC）的风险模型，该模型定义为后囊破裂和/或悬韧带离断，并将先前的玻璃体腔内治疗（pIVT）纳入模型。
本回顾性基于登记的研究涵盖了 2010 年 1 月 1 日至 2018 年 6 月 30 日期间向瑞典国家白内障登记处（SNCR）报告的患者。使用比值比（ORs）来量化每个变量与 IC 的关联强度。从 SNCR 获得的数据与瑞典黄斑登记处交叉引用，以纳入 pIVT 数据。单变量分析中具有统计学意义的变量（p<0.05）被纳入多变量逻辑回归模型。
符合纳入标准的患者有 907499 只眼。IC 的总体发生率为 0.86%。与 IC 显著相关的变量包括最佳矫正视力≥1.0 LogMAR（OR（调整）：1.75，p<0.001）、年龄≥90 岁（OR：1.25，p<0.001）、男性（OR：1.09，p<0.01）、假性剥脱综合征（OR：1.33，p<0.001）、青光眼（OR：1.11，p<0.05）、糖尿病视网膜病变（OR：1.35，p<0.001）、pIVT（OR：1.45，p<0.05）、手术医生经验<600 例手术（OR：2.77，p<0.001）、使用撕囊钩（OR：6.14，p<0.001）、蓝色染色（OR：1.87，p<0.001）和机械瞳孔扩张（OR：1.52，p<0.001）。
该风险模型可用于术前预测 IC 的概率，以辅助手术计划并改善患者沟通。在白内障手术前接受过玻璃体腔内治疗的患者，在白内障手术中发生 IC 的风险增加。
