Thylefors Joakim, Jakobsson Gunnar, Zetterberg Madeleine, Sheikh Rafi
Ophthalmology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.
Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Västra Götaland, Sweden.
Clin Ophthalmol. 2023 Jul 12;17:1975-1980. doi: 10.2147/OPTH.S410585. eCollection 2023.
To analyze preoperative visual acuity before cataract surgery regarding the risk of rhegmatogenous retinal detachment (RRD) after cataract surgery.
The preoperative visual acuity in an observational cohort study of patients undergoing cataract surgery in Skåne, southern Sweden, during 2015-2017 was analyzed with data retrieved from the Swedish National Cataract Register. This was then cross-referenced with patients undergoing surgery for retinal detachment at the Skåne University Hospital in Lund from 2015 to 2020. The main outcome was the risk-benefit ratio of measuring preoperative visual acuity before cataract surgery and the risk of RRD.
The mean visual acuity in the whole study group (N=58,624), expressed as LogMAR, was 0.40 ± 0.32 (SD). In the group with RRD (n=298), the mean visual acuity was 0.44 ± 0.36 (=0.07). In the subgroups of RRD, those aged <60 years 0.49 ± 0.44 (=0.07), aged <60 years and axial length (AL) >25 mm 0.42 ± 0.38 (=0.68), and in those aged <60 years, AL >25 mm and male sex 0.44 ± 0.39 (=0.53). However, there is considerable variations in visual acuity of the various groups and in the high-risk group with RRD aged <60 years with AL>25 mm, 15% had a visual acuity of 0.8 or better in the operated eye.
There must be strong indications for performing cataract surgery in those with a high risk of retinal detachment, and the patient must be given adequate information on the risk of retinal detachment.
分析白内障手术前的视力与白内障手术后孔源性视网膜脱离（RRD）风险之间的关系。
利用从瑞典国家白内障登记处检索到的数据，对2015 - 2017年期间在瑞典南部斯科讷接受白内障手术的患者进行观察性队列研究，分析其术前视力。然后将这些数据与2015年至2020年在隆德的斯科讷大学医院接受视网膜脱离手术的患者进行交叉对照。主要结果是白内障手术前测量视力的风险效益比以及RRD的风险。
整个研究组（N = 58,624）的平均视力，以LogMAR表示，为0.40±0.32（标准差）。在发生RRD的组（n = 298）中，平均视力为0.44±0.36（P = 0.07）。在RRD的亚组中，年龄<60岁的患者平均视力为0.49±0.44（P = 0.07），年龄<60岁且眼轴长度（AL）>25mm的患者平均视力为0.42±0.38（P = 0.68），年龄<60岁、AL>25mm且为男性的患者平均视力为0.44±0.39（P = 0.53）。然而，各亚组的视力存在相当大的差异，在年龄<60岁、AL>25mm的RRD高风险组中，15%的患者患眼视力为0.8或更好。
对于视网膜脱离风险高的患者，必须有强烈的白内障手术指征，并且必须向患者充分告知视网膜脱离的风险。
