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白内障结局测量标准的制定:一家意大利三级转诊中心的经验。

Cataract standard set for outcome measures: An Italian tertiary referral centre experience.

作者信息

Tognetto Daniele, Giglio Rosa, De Giacinto Chiara, Dell'Aquila Carmen, Pian Giulia, Scardellato Carlo, Piñero David Pablo

机构信息

Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy.

Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.

出版信息

Eur J Ophthalmol. 2021 May 31:11206721211018370. doi: 10.1177/11206721211018370.

Abstract

PURPOSE

Implementation of the International Consortium for Health Outcomes Measurements (ICHOM) standard for cataract surgery into clinical practice at an Italian tertiary referral centre.

METHODS

Prospective, observational, descriptive study consisting of the registry and analysis of cataract surgeries performed during a 6-month enrolment period at the University Eye Clinic of Trieste, Trieste, Italy. Outcomes were recorded and analysed according to the ICHOM Cataract Standard Set version 2.0.1. Records included clinician-reported outcome measures (CROMs) - visual outcome and complications - and patient-reported outcome measures (PROMs) - self-assessed vision with the Catquest-9SF questionnaire. Correlations between PROMs and CROMs were evaluated. A multiple linear regression was used for predicting the change in PROMs with surgery.

RESULTS

A total of 218 eyes (of 218 patients) were analysed. Postoperative corrected distance visual acuity (CDVA) was ⩾0.3 in 89.0% (194/218) of eyes. There was a statistically significant improvement of the post-operative Catquest-9SF global average score. ( < 0.001). The change in the Catquest-9SF score significantly correlated with the change in Item 2 score (related to intermediate vision) ( = 0.634,  < 0.001). A predictive model of the change in the Catquest-9SF score was found ( < 0.001, : 0.527) based on preoperative Catquest-9SF total score, presence or not of macular degeneration, presence or not of intraoperative complications, age >75 years old, and preoperative CDVA.

CONCLUSIONS

Cataract surgery improves the functional vision, with some factors limiting the outcomes such as comorbidities. Self-perceived improvement in intermediate vision significantly influenced the improvement in self-assessed vision.

摘要

目的

在意大利一家三级转诊中心将国际健康结局测量协会(ICHOM)白内障手术标准应用于临床实践。

方法

前瞻性、观察性、描述性研究,包括对意大利的里雅斯特大学眼科诊所6个月入组期内进行的白内障手术进行登记和分析。根据ICHOM白内障标准集2.0.1记录并分析结果。记录包括临床医生报告的结局指标(CROMs)——视力结局和并发症,以及患者报告的结局指标(PROMs)——使用Catquest - 9SF问卷进行的自我视力评估。评估PROMs与CROMs之间的相关性。采用多元线性回归预测手术前后PROMs的变化。

结果

共分析了218例患者的218只眼。89.0%(194/218)的患眼术后矫正远视力(CDVA)≥0.3。术后Catquest - 9SF总体平均得分有统计学显著改善(P < 0.001)。Catquest - 9SF得分的变化与第2项得分(与中间视力有关)的变化显著相关(r = 0.634,P < 0.001)。基于术前Catquest - 9SF总分、是否存在黄斑变性、是否存在术中并发症、年龄>75岁以及术前CDVA,发现了Catquest - 9SF得分变化的预测模型(P < 0.001,R²:0.527)。

结论

白内障手术可改善功能性视力,但一些因素如合并症会限制手术效果。自我感觉中间视力的改善对自我评估视力的改善有显著影响。

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