Strong Caldwell Anne, Patnaik Jennifer L, Ackerman Melisa, Christopher Karen L, Lynch Anne M, Singh Jasleen K
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Ophthalmology, Children's Hospital of Colorado, Aurora, CO, USA.
Clin Ophthalmol. 2021 Nov 11;15:4431-4438. doi: 10.2147/OPTH.S337360. eCollection 2021.
To investigate the risk of unexpected refractive prediction error after cataract surgery in patients with thyroid eye disease (TED) at the University of Colorado.
A retrospective observational study was performed using records of patients who underwent cataract surgery (2014 to 2018) who were included in a Cataract Surgery Outcomes database. Any patient with documentation of thyroid eye disease (TED) in the medical record was classified as TED. Post-operative refraction error greater than or equal to ±1.0 diopter from the target refraction was the main outcome of this study. Eyes with history of refractive surgery, ocular trauma, retinal detachment, non-Graves' disease thyroid conditions or Graves' disease without TED, and eyes without refractive error at follow-up were excluded.
A total of 5716 eyes from 3692 patients who underwent cataract surgery were analyzed. Sixty-five eyes of thirty-nine patients (1.1%) had TED. Former and/or current cigarette use was associated with having TED (p = 0.0504). Patients with TED had a statistically significant shorter axial length as compared to eyes without TED (p = 0.0257). Three hundred and forty-nine eyes (6.1%), including 9 eyes (13.8%) in patients with TED, had refractive prediction error greater than ±1.0 diopter following surgery (univariate OR = 2.5, 95% CI: 1.1-5.7, p = 0.0274). After multivariate analysis controlling for race, tobacco use, combined surgery, and axial length, TED was associated with an increased risk of our primary outcome, refractive prediction error greater than ±1.0 diopter (OR = 2.4, 95% CI: 1.0-5.7, p = 0.0506).
Patients with TED are at increased risk for refractive prediction error following cataract surgery. Discussion with patients regarding their risk and possible need for glasses following surgery is important for setting realistic patient expectations.
调查科罗拉多大学甲状腺眼病（TED）患者白内障手术后意外屈光预测误差的风险。
采用白内障手术结果数据库中2014年至2018年接受白内障手术患者的记录进行回顾性观察研究。病历中有甲状腺眼病（TED）记录的任何患者被归类为TED。术后屈光误差大于或等于目标屈光±1.0屈光度是本研究的主要结果。排除有屈光手术史、眼外伤、视网膜脱离、非格雷夫斯病甲状腺疾病或无TED的格雷夫斯病的眼睛，以及随访时无屈光误差的眼睛。
共分析了3692例接受白内障手术患者的5716只眼睛。39例患者的65只眼睛（1.1%）患有TED。既往和/或目前吸烟与患有TED相关（p = 0.0504）。与无TED的眼睛相比，患有TED的患者眼轴长度在统计学上显著更短（p = 0.0257）。349只眼睛（6.1%），包括TED患者中的9只眼睛（13.8%），术后屈光预测误差大于±1.0屈光度（单因素OR = 2.5，95% CI：1.1 - 5.7，p = 0.0274）。在对种族、烟草使用、联合手术和眼轴长度进行多因素分析后，TED与我们的主要结果即屈光预测误差大于±1.0屈光度的风险增加相关（OR = 2.4，95% CI：1.0 - 5.7，p = 0.0506）。
TED患者白内障手术后屈光预测误差风险增加。与患者讨论其风险以及术后可能需要眼镜的情况对于设定患者现实的期望很重要。
