Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
University Hospitals Eye Institute, Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio; Department of Ophthalmology, Assiut University Hospitals, Faculty of Medicine, Assiut, Egypt.
Ophthalmology. 2023 Jun;130(6):640-645. doi: 10.1016/j.ophtha.2023.01.019. Epub 2023 Feb 3.
To quantify the risk of pseudophakic cystoid macular edema (pCME) in fellow-eye cataract surgery and to determine risk factors, including prior first-eye pCME.
Retrospective, clinical database study.
Patients undergoing bilateral nonsimultaneous cataract surgeries in 8 UK National Health Service clinical centers between July 2003 and March 2015.
We excluded patients with a history of diabetic macular edema (DME) or CME and perioperative topical nonsteroidal anti-inflammatory drug use in either eye. We calculated the overall risk of pCME and used Poisson model with robust estimation of standard error to identify potential risk factors for pCME in the fellow eye.
The risk of postoperative clinical pCME in the fellow eye.
A total of 54 209 patients were included. The mean age was 74.6 ± 10.4 years, and 38.8% were male. The fellow eye developed pCME in 544 patients (1%). The risk of fellow-eye pCME among patients without first-eye pCME was 0.9%. However, the risk of fellow-eye pCME among those with first-eye pCME was 10.7%. In the fully adjusted model, we found that the risk factors for the development of fellow-eye pCME were first-eye pCME (RR, 8.55, 95% confidence interval [CI], 6.19-11.8), epiretinal membrane (ERM) (RR, 4.1, CI, 2.63-6.19), history of retinal vein occlusion (RR, 2.94, CI, 1.75-4.93), diabetes without history of DME (RR, 2.08, CI, 1.73-2.5), advanced cataract (RR, 1.75, CI, 1.16-2.65), prostaglandin analogue use preoperatively (RR, 1.49, CI, 1.13-1.97), and male sex (RR, 1.19, CI, 1.0-1.41).
History of pCME in the first-operated eye is the strongest independent risk factor for the development of pCME in the fellow eye. Our findings may guide clinicians in counseling patients on the risk of pCME before performing cataract surgery in the fellow eye and help in identifying high-risk patients who may benefit from prophylactic therapy.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
定量分析对侧眼白内障术后发生假性囊膜下黄斑水肿（pCME）的风险，并确定包括先前第一只眼 pCME 在内的风险因素。
回顾性临床数据库研究。
2003 年 7 月至 2015 年 3 月期间，8 家英国国家卫生服务临床中心接受双侧非同期白内障手术的患者。
我们排除了有糖尿病性黄斑水肿（DME）或 CME 病史以及围手术期双眼使用非甾体类抗炎药的患者。我们计算了 pCME 的总体风险，并使用泊松模型和稳健标准误差估计来确定对侧眼 pCME 的潜在风险因素。
对侧眼术后临床 pCME 的风险。
共纳入 54209 例患者。平均年龄为 74.6±10.4 岁，38.8%为男性。544 例（1%）患者对侧眼发生 pCME。无第一只眼 pCME 的患者对侧眼 pCME 的风险为 0.9%。然而，有第一只眼 pCME 的患者对侧眼 pCME 的风险为 10.7%。在完全调整模型中，我们发现对侧眼 pCME 发生的危险因素包括第一只眼 pCME（RR，8.55，95%置信区间[CI]，6.19-11.8）、视网膜内膜（RR，4.1，CI，2.63-6.19）、视网膜静脉阻塞史（RR，2.94，CI，1.75-4.93）、无 DME 病史的糖尿病（RR，2.08，CI，1.73-2.5）、高级别白内障（RR，1.75，CI，1.16-2.65）、术前使用前列腺素类似物（RR，1.49，CI，1.13-1.97）和男性（RR，1.19，CI，1.0-1.41）。
第一只眼 pCME 史是对侧眼发生 pCME 的最强独立危险因素。我们的研究结果可能有助于指导临床医生在对侧眼行白内障手术前向患者告知 pCME 的风险，并帮助识别可能受益于预防性治疗的高危患者。
参考文献后可能有专有或商业披露。
