澳大利亚伊拉瓦拉-肖尔黑文地方卫生区白内障手术后假晶状体囊样黄斑水肿的发病率

Incidence of Pseudophakic Cystoid Macular Oedema Post-Cataract Surgery in Illawarra Shoalhaven Local Health District, Australia.

作者信息

Seth Ishith, Bulloch Gabriella, Tan Alvin, Thornell Erin, Agarwal Smita

机构信息

Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia.

Faculty of Science, Medicine and Health, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Biomed Hub. 2022 Jan 18;7(1):1-10. doi: 10.1159/000521053. eCollection 2022.

DOI:10.1159/000521053

PMID:35223872

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8832185/

Abstract

BACKGROUND

Post-operatively, cataract surgery is associated with pseudophakic cystoid macular oedema (PCMO) causing vision disturbances. The presence of comorbidities may increase the incidence of PCMO post-cataract surgery.

OBJECTIVE

This observational study aimed to assess the incidence of PCMO in Australia (Illawarra region) and identify risk factors for developing PCMO.

METHODS

Retrospective analysis was performed on data from patients who underwent uncomplicated phacoemulsification and intraocular lens implantation between 1st March and June 30, 2016. Demographics, comorbidities, central subfield thickness (CST), visual acuity, and intraocular pressure (IOP) were collected preoperatively, day 1, and weeks 2, 4, and 6 post-operatively. Statistical analysis was performed using SPSS v.27.0 and GraphPad Prism v.9.0. The median and 95% confidence intervals were used to describe data. Logistic regression and χ tests were used to describe the associations. We followed the Declaration of Helsinki guidelines.

RESULTS

Fifty right and 35 left cataract eyes were operated on (58.8% were females; average age 72.8 ± 8.146 years). Total PCMO incidence was 10.6%, and true PCMO incidence (removing PCMO risk factors) was 4.2% at week 6 post-operatively. CST was slightly increased between pre- and post-cataract surgery at week 4 ( = 0.002) and week 6 ( < 0.0001; median = 259 μm, 264 μm, and 263 μm, respectively). IOP was found to be decreased ( < 0.0001) compared to day 1 (median = 17 mm Hg) and week 6 (median = 13 mm Hg). The probability of developing PCMO (odds ratio [OR] = 3) and vitreomacular traction (OR = 2.9) was higher in diabetic patients compared to non-diabetic patients and in patients >65 years old (OR = 1.5).

CONCLUSION

The true incidence of PCMO was found to be the greatest at 2-4 weeks post-operatively. Patients with diabetes or advanced age (>65 years) are at an elevated risk of developing PCMO after cataract surgery. The treatment regimens for the comorbid populations, especially diabetic patients, remain limited, and future efforts should target pharmaceutical management for these groups.

摘要

背景

白内障手术后常伴有人工晶状体性黄斑囊样水肿（PCMO），可导致视力障碍。合并症的存在可能会增加白内障手术后PCMO的发生率。

目的

本观察性研究旨在评估澳大利亚（伊拉瓦拉地区）PCMO的发生率，并确定发生PCMO的危险因素。

方法

对2016年3月1日至6月30日期间接受单纯超声乳化白内障吸除术和人工晶状体植入术的患者数据进行回顾性分析。收集术前、术后第1天、术后第2周、第4周和第6周的人口统计学资料、合并症、中心子野厚度（CST）、视力和眼压（IOP）。使用SPSS v.27.0和GraphPad Prism v.9.0进行统计分析。采用中位数和95%置信区间描述数据。使用逻辑回归和χ检验描述相关性。本研究遵循赫尔辛基宣言指南。

结果

共对50只右眼和35只左眼进行了白内障手术（女性占58.8%；平均年龄72.8±8.146岁）。术后第6周，PCMO总发生率为10.6%，去除PCMO危险因素后的实际发生率为4.2%。术后第4周（P = 0.002）和第6周（P < 0.0001；中位数分别为259μm、264μm和263μm），白内障手术前后CST略有增加。与术后第1天（中位数 = 17 mmHg）和第6周（中位数 = 13 mmHg）相比，眼压降低（P < 0.0001）。与非糖尿病患者相比，糖尿病患者发生PCMO（比值比[OR] = 3）和玻璃体黄斑牵拉（OR = 2.9）的概率更高，65岁以上患者发生PCMO的概率也更高（OR = 1.5）。